| NPI | 1427388388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK JAMES MALONE Owner 208-924-5364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2009-12-28 |