| NPI | 1770757023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI VOLKERS Owner 208-233-9709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ID 1127) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2008-04-17 |