| NPI | 1265912919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA DICKERSON Clinical Director 208-995-3615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CA 1-14-10119) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-14-10119) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2024-07-29 |