| NPI | 1336875855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY OGATA Clinical Social Worker 208-761-2055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2023-08-28 |