| NPI | 1477605806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA MADREE MILES General Partner 208-964-4879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2010-02-12 |