| NPI | 1518097997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DEE STEPHENSON Owner 208-782-0675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCSW 26187) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2014-08-04 |