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