| NPI | 1477994580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS HARDZIEJ Director 208-336-6792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: ID LMSW-29111) |
| Enumeration Date | 2013-07-17 |
| Last Update Date | 2013-07-17 |