| NPI | 1861864712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY ALVAREZ CEO 208-238-5493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: ID P5176) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2015-10-30 |