| NPI | 1568143550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACH JENSON CEO 385-352-9746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 163WA0400X Registered Nurse Addiction (Substance Use Disorder) | |
| 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult | |
| 2083A0300X Preventive Medicine Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-07-31 |