| NPI | 1013535145 |
|---|---|
| Doing Business As | REVITALIZE COUNSELING CENTER |
| Entity Type | Organization |
| Authorized Contact | LAURA L GAYLER President/Owner 208-997-3077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-07-06 |