| NPI | 1073174595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE M PERUSSE Owner/Clinician 208-920-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-06-25 |