| NPI | 1003145533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE HAGEL President 208-930-1740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 101YP2500X Counselor Professional | |
| 1041C0700X Social Worker Clinical | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 251B00000X Case Management | |
| Enumeration Date | 2009-12-11 |
| Last Update Date | 2023-10-12 |