| NPI | 1730357047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MONTGOMERY Owner 208-323-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ID M9072) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-03-10 |