| NPI | 1427419647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BIDIMAN Director/Owner 208-596-2701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 363LC1500X Nurse Practitioner, Community Health | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2025-04-16 |