| NPI | 1316551187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE LYN HANSEN Owner 208-915-8448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| 251B00000X Case Management | |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2024-04-29 |