| NPI | 1437671047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNY KELL HENSON President 208-215-1407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2017-07-14 |