| NPI | 1124407093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA K BOWEN Owner 208-484-3017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCSW-34585) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |