| NPI | 1750621116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRIN B ROBERTSON Owner 208-380-0194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: ID NP1034A) |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2014-09-03 |