| NPI | 1174979470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA HANSEN Owner 208-887-1911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-34104) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2016-05-05 |