| NPI | 1396254066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY DAWN SMOTHERS Owner 208-293-8846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LPC-6156) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2025-06-16 |