| NPI | 1558639971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON DUNBAR Billing Manager 208-954-5572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M-11479) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |