| NPI | 1811153844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA DAWN HOUSTON-POWELL Co President 208-308-2410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2008-07-30 |