| NPI | 1487943304 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JULI A BARDSLEY Owner 208-639-8839  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID 4452)  | 
| Enumeration Date | 2011-03-31 | 
| Last Update Date | 2011-03-31 |