| NPI | 1508646860 |
|---|---|
| Doing Business As | GEM STATE WELLNESS |
| Entity Type | Organization |
| Authorized Contact | MATTHEW SCHUBERT Owner 208-615-9828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2023-10-04 |
| Last Update Date | 2023-10-10 |