| NPI | 1952711996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES GRIGGS Owner 208-750-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LPC-2908) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: WA LF- 60140407) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2014-04-29 |