| NPI | 1548993140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN CHRISTINE GILLILAND Owner 208-640-6756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-07-01 |
| Last Update Date | 2022-07-01 |