| NPI | 1366697575 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ALICIA ANN GABICA-GRAND Mental Health Therapist 208-265-5049  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LMSW-29175)  | 
| Enumeration Date | 2008-12-02 | 
| Last Update Date | 2008-12-02 |