| NPI | 1609010495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH KNACK Mental Health Intake Specialist 208-457-1540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: ID LMSW-29144) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2009-04-24 |