| NPI | 1992132427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM TUELLER Owner 208-524-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: ID CADC 10090) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2013-09-30 |