| NPI | 1750566386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON HOUSTON CFO 208-734-3312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 122300000X Dentist | |
| 124Q00000X Dental Hygienist | |
| 133V00000X Dietitian, Registered | |
| 207Q00000X Family Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2012-12-19 |