| NPI | 1336316207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M. MIKELL ZIMMERMAN President 208-597-3553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LPC-3664) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LPC-3664) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2008-05-09 |