| NPI | 1194268169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY GRATTON Owner 208-576-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCSW27506) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2023-04-19 |