| NPI | 1487207049 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JENNIFER RENEE GUZMAN Owner/Clinician 208-919-6310  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2019-07-22 | 
| Last Update Date | 2022-06-07 |