| NPI | 1497888713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK R. KORENKE Owner 208-200-4818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ID LCPC-2788) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2016-02-23 |