| NPI | 1679287296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA JEAN NIELSON Manager 208-284-7233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-01-09 |