| NPI | 1063762672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID NICHOLS Co Owner 208-918-6466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LPC-5048) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2012-09-12 |