| NPI | 1982045464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY ANN MARTINEZ LLC Member/Manager 208-407-1857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-08-19 |