| NPI | 1538436647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM DANIELS Manager 208-344-9797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2011-11-18 |
| Last Update Date | 2012-04-27 |