| NPI | 1801306873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JOHN PINES Owner 208-995-9272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ID 0184) |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2021-04-21 |