| NPI | 1215365523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE STEVENS Owner 208-263-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCPC-4183) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2025-10-27 |