NPI | 1811374432 |
---|---|
Entity Type | Organization |
Authorized Contact | WENDY SEAGRAVES Clinical Supervisor 208-287-5624 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID 22) |
Enumeration Date | 2015-05-04 |
Last Update Date | 2015-05-04 |