| NPI | 1184769994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER FOWLER Director 208-476-7483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCSW-31240) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCSW-26572) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2025-01-02 |