| NPI | 1396110458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON DUNBAR Billing Manager 208-954-5573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ID M-11136) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |