| NPI | 1477155901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA GILBERT CEO 208-810-2704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2024-07-22 |