| NPI | 1538485685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON HOUSTON CFO 208-734-3312 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2012-12-19 |