| NPI | 1366934283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN J BRILEY Director 208-451-0101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-28826) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-06 |