| NPI | 1659530103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHI A NELSON Office Manager 208-461-5459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: ID D3936PD) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |