| NPI | 1902777527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAKE MCKEE Pmhnp 208-999-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-09-16 |
| Last Update Date | 2025-09-16 |