| NPI | 1881072817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECCA FAHEY Office Manager 208-664-2468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage (Licence: ID OT-1455) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |