| NPI | 1366174088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA MURPHY Medical Staff COO Rdinator 208-232-7862 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2022-06-30 |