| NPI | 1427813658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG LIPPERT Owner 208-929-6845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2024-02-16 |