| NPI | 1598900193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA MURPHY Medical Staff Coordinator 208-232-7862 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2020-08-17 |