| NPI | 1487370052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ANTHONY TEED President 208-484-1446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-17 |