| NPI | 1083127740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENA KATHLEEN SCHILDHAUER Owner/Clinician 208-358-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: ID LCSW-37032) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2017-11-15 |