| NPI | 1568544047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM A GRIGG Owner 208-922-9001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-407) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2012-03-28 |