| NPI | 1346410321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL KLETT VANCE Physician 208-523-4688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0008X Pediatrics, Neurodevelopmental Disabilities (Licence: ID M9751) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |