| NPI | 1467268235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON PAUL KRUSE Owner 208-880-5890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-12-06 |
| Last Update Date | 2024-12-13 |