| NPI | 1962705939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATH JACOB SOMMER CEO 208-237-9833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: ID psy202423) |
| Enumeration Date | 2010-12-14 |
| Last Update Date | 2010-12-14 |