| NPI | 1528366424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY LYNN RICHARDSON Owner 208-242-3771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251B00000X Case Management | |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2020-02-25 |