| NPI | 1467002923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROM GLIDDEN Owner 208-597-0994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 104100000X Social Worker |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2020-05-20 |