| NPI | 1588918817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALI BERLIN Owner 208-678-3555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2012-11-29 |