| NPI | 1659597490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA J PERRENOUD Director 208-785-1326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: DON'T HAVE ONE) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |