| NPI | 1720119225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUKE MORTON Field Services Program Manager 208-736-2177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |