| NPI | 1386778959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRAN CARADINE Clinician Owner 208-798-1646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID 04-213476) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2009-10-16 |