| NPI | 1730504309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SETH F WINTERHOLLER Owner 208-404-2184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2024-07-18 |