| NPI | 1912059361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAFAWN M HAMM Executive Director 208-798-5132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID 1109) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2008-08-08 |