| NPI | 1982012662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA LEE MATTHEWS Lm T 208-940-2053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: OR 19679) |
| Enumeration Date | 2014-07-26 |
| Last Update Date | 2014-07-26 |