| NPI | 1689809402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BEARD Owner 208-733-7186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LPC 4078) |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2024-03-13 |