| NPI | 1558498097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD L HURT Field Operations Manager 208-455-7057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |