| NPI | 1215159819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBETTE RENEE PAGE Owner 208-552-6900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-27373) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |