| NPI | 1083326219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE HOBBS Member 208-705-6771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2022-12-19 |