| NPI | 1770728040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIE ROCK Office Manager 208-357-7774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: ID M-9188) |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2008-12-15 |