| NPI | 1588942304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE CARROLL Owner 208-642-3396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-1159) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2011-10-19 |