NPI | 1275262727 |
---|---|
Entity Type | Organization |
Authorized Contact | AMI OWEN Owner 208-740-0544 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
Enumeration Date | 2022-06-09 |
Last Update Date | 2024-03-05 |