| NPI | 1710041785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD V WINDER Administrator 208-766-2231 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: ID 138509) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2008-03-14 |