| NPI | 1134361207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ROBERT JONES Owner 208-743-8101 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: ID LCPC4218) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: ID LCSW1120) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2009-04-03 |