| NPI | 1477115384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY TOPP Director Of Operations 208-304-5499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2024-02-21 |