| NPI | 1417216961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEED MARTIN Owner/Director 208-478-2172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2012-11-01 |