| NPI | 1134338791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA WHARTON Master Social Worker 208-353-2496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LMSW-25856) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |