| NPI | 1417646266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BEZZANT Owner 208-970-9087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-05-05 |