| NPI | 1053827840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANNA THORESON Clinical Therapist 208-263-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ID LCSW-29702) |
| Enumeration Date | 2017-12-16 |
| Last Update Date | 2017-12-16 |