| NPI | 1356959191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY FREER Owner 208-819-5415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-11-10 |