| NPI | 1528396884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE STEPHENSON Owner 208-703-9771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LPC-3034) |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2009-11-25 |