| NPI | 1588398911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA PIERCE Licensed Clinical Social Worker 208-914-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-12 |