| NPI | 1528704350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY PEREZ Owner 208-859-9110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2022-05-05 |