| NPI | 1366105199 |
|---|---|
| Doing Business As | MIND MED MENTAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | CAMILLE ELLEN PINCOCK Owner 208-720-3948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2023-04-17 |