| NPI | 1265286561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI NELSON Clinical Supervisor 208-221-9069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-04-15 |