| NPI | 1609170471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF K WILLIAMS Owner 208-659-3527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ID LCSW26516) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: ID LCSW-26516) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2013-11-05 |