| NPI | 1962553792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA JO PERRENOUD Director And Clinician 208-524-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: ID Do not have one) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |