| NPI | 1770847311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE CHENEY Business Manager 208-955-1601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2012-06-28 |