| NPI | 1427108323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MICHELLE SMITH Program Director 208-523-1130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 103G00000X Clinical Neuropsychologist | |
| 103TC0700X Psychologist, Clinical | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2023-01-23 |