| NPI | 1477766905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE TUELLER CFO 208-604-1927 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2025-05-29 |