| NPI | 1477122570 |
|---|---|
| Doing Business As | MADISON MEMORIAL BEHAVIORAL HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | RACHEL GONZALES Chief Executive Officer 208-359-6900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 104100000X Social Worker |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2023-10-23 |