| NPI | 1073267654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB SIEGBERG CEO 208-918-3835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2022-02-11 |