NPI | 1639476294 |
---|---|
Entity Type | Organization |
Authorized Contact | VICKI MALONE Program Manager 208-799-4440 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
Enumeration Date | 2011-02-17 |
Last Update Date | 2011-02-17 |