| NPI | 1750882635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA RUTH Owner 208-841-1704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2018-02-26 |