| NPI | 1821715319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMI ECHI-ABOLI Billing Department Director 208-360-1038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2026-01-06 |