| NPI | 1396326096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERJURIE F RICKLEFS Psychiatric Nurse Practitioner 208-821-0357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2021-05-06 |