| NPI | 1457309122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD CURTIS Director Of Revenue 208-323-9613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2024-02-05 |