| NPI | 1164964045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIMIE LEE CAIN Social Worker 208-440-5125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCSW-35753) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |