NPI | 1457831786 |
---|---|
Entity Type | Organization |
Authorized Contact | KIRA JEAN BURGESS-ELMER Owner 208-488-2557 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCPC-6287) |
Enumeration Date | 2018-08-16 |
Last Update Date | 2018-08-16 |