| NPI | 1932552379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULI POPEJOY Billing Manager 208-525-2090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: ID M-9188) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2016-09-28 |