| NPI | 1689349219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEE LYNNE SWANDER Director Of Nursing 208-992-4119 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2022-08-26 |