NPI | 1518217983 |
---|---|
Entity Type | Organization |
Authorized Contact | JANET RUTH LOVELAND Counselor 208-312-2510 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: ID 3745) |
Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: ID 3745) |
Enumeration Date | 2012-09-13 |
Last Update Date | 2012-09-13 |