NPI: 1306302898 · PAUL, ID 83347 · Community/Behavioral Health Agency · NPI assigned 02/20/2019
| Authorized Official | RAYVONTI, TARA (ADMINISTRATION) |
| NPI Enumeration Date | 02/20/2019 |
| Year | Claims | Total Paid |
|---|---|---|
| 2019 | 67 | $4K |
| 2020 | 42 | $3K |
| 2022 | 42 | $4K |
| 2024 | 27 | $4K |