| NPI | 1730870544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTY STIBAL Director Of Operations 208-821-1032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2023-06-05 |