NPI | 1700890068 |
---|---|
Entity Type | Organization |
Authorized Contact | RONA M BRUMPTON President 208-859-7435 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: ID LMFT-2861, LCPC-378) |
Enumeration Date | 2006-07-29 |
Last Update Date | 2011-10-23 |