| NPI | 1336019629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAILENE JEAN DONALDSON Owner 208-250-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-11-11 |
| Last Update Date | 2026-02-02 |