NPI | 1588006217 |
---|---|
Entity Type | Organization |
Authorized Contact | WADE GORDON Owner 208-356-5675 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCSW 27205) |
Enumeration Date | 2013-07-23 |
Last Update Date | 2013-07-23 |