| NPI | 1366593964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA JO PERRENOUD Director And Clinician 208-785-1326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: ID Do not have one) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |