| NPI | 1881840593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA JANE HAGEN Owner 208-323-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ID M9410) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2009-04-28 |