| NPI | 1407638992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MICHELLE MILLER CEO/Owner 208-890-6205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172V00000X Community Health Worker | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 175T00000X Peer Specialist | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| Enumeration Date | 2023-10-18 |
| Last Update Date | 2023-11-08 |