| NPI | 1518628296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRA URIAS Social Worker 208-714-6922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-01-05 |
| Last Update Date | 2022-01-05 |