| NPI | 1952571234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORAINE M GUMPER Owner 208-735-2442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: ID CHIA-754) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-03-03 |