| NPI | 1104564426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ANN HAMMACK Owner/Clinician 208-283-6577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2022-11-06 |