| NPI | 1588986376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM ANDERSON GRIGG Owner 208-991-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCPC-407) |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2012-04-17 |