| NPI | 1902084833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY C. JAQUES Occupational Therapist/Owner 208-782-2267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: ID OT-232) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: ID OT-232) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2008-02-01 |