| NPI | 1306543228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN FAYE TORNKVIST Chief Administrator 208-360-8102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251B00000X Case Management |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2023-02-10 |
| Last Update Date | 2023-02-10 |