| NPI | 1902791932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE NICHOLE BROWN Owner/Provider 208-681-9453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-08-05 |