| NPI | 1891996526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANNA KOSTER Supervisor 208-522-5545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ID LMSW-30182) |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: ID LMSW-30182) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: ID LMSW-30182) | |
| 171M00000X Case Manager/Care Coordinator | |
| 252Y00000X Early Intervention Provider Agency | |
| 251J00000X Nursing Care (Licence: ID N-34382) | |
| 163W00000X Registered Nurse (Licence: ID N-32598) | |
| 104100000X Social Worker (Licence: ID LMSW-30182) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID NP-386A) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2012-06-12 |