| NPI | 1366033094 | 
|---|---|
| Other Name | ISU INTEGRATED MENTAL HEALTH | 
| Entity Type | Organization | 
| Authorized Contact | CYNTHIA LEE ROCK Clinics Director Of Operations 208-373-1743  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health | 
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy | 
| Enumeration Date | 2021-01-26 | 
| Last Update Date | 2021-08-27 |