| NPI | 1831308113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MARIE SIX President 208-354-3601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |