| NPI | 1083997738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HAVENS Owner 208-529-1660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2012-01-19 |