| NPI | 1295353217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLY IRELAND Office Manager/Admin Supervisor 208-699-6817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-07-07 |