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 |