| NPI | 1790006419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERONICA SALAZAR President/Owner 208-989-7699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LPC-4098) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2010-06-16 |