| NPI | 1598012700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHARY STEPHEN HADDON-DENNIS Billing Manager 208-524-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2026-06-10 |