| NPI | 1962525717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE ELAINE MOORE Administrator 208-524-0881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: ID 806694900) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |