| NPI | 1821673716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENT P TURNER Member 208-262-4209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2022-06-01 |