| NPI | 1861046039 |
|---|---|
| Doing Business As | SHOSHONE BANNOCK JR/SR HIGH |
| Entity Type | Organization |
| Authorized Contact | AMELIA MURPHY Medical Staff Coordinator 208-232-7862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2019-07-26 |