| NPI | 1417084716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY BONWELL Program Manager 208-769-1406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2016-08-25 |