| NPI | 1861869786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J JOHANNSEN Administrator 208-455-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: ID 152380008) |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2015-08-26 |