| NPI | 1417300955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE CLOHESSY Clinical Director 208-333-0008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID SE-202926) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-20 |