| NPI | 1922243088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB ERICKSON CEO 208-785-3801 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| 261Q00000X Clinic/Center | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2024-04-01 |