| NPI | 1508636770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE MARIE ELSBREE Clinical Social Worker 208-243-9152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-10-01 |