| NPI | 1326386202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH REAGAN L Icensed Clinical Professional Coun 208-284-7208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ID LCPC-3441) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2013-02-13 |