| NPI | 1467924985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINT HARDY State Administrator/CEO 208-390-3870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Additional Taxonomies | 163WC0400X Registered Nurse Case Management |
| 163WH0200X Registered Nurse Home Health | |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2018-12-21 |