NPI | 1356968895 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNIFER ANN HAWKINS Co Owner 208-889-8594 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2020-07-01 |
Last Update Date | 2020-07-01 |