NPI | 1124590302 |
---|---|
Entity Type | Organization |
Authorized Contact | PENNEY ROCKHILL Counselor 208-419-6102 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2018-12-27 |
Last Update Date | 2024-01-16 |