| NPI | 1396189957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY LYNN FOWLER Executive Director/ Owner 208-413-2619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2016-06-23 |