| NPI | 1427437383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY JO ANDREW Clinical Director 208-236-7089 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |