| NPI | 1780877456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN ALAN NETTLES Director 208-467-4889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2007-08-24 |
| Last Update Date | 2010-06-24 |