| NPI | 1104404805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY JIANAS Owner, Lmft 208-557-1517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-04-01 |
| Last Update Date | 2025-02-16 |