| NPI | 1912395724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY BETTS Business Manager 208-886-3131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2026-02-19 |