| NPI | 1750396636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK E SHULL Owner 208-746-6776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |