| NPI | 1790171213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON BINDER Owner 208-891-6647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |