| NPI | 1497235469 |
|---|---|
| Doing Business As | LOST RIVER WELLNESS |
| Entity Type | Organization |
| Authorized Contact | JEFF BROWN Chief Business Officer 208-484-1447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: ID M11538) |
| Enumeration Date | 2018-08-18 |
| Last Update Date | 2018-11-28 |