| NPI | 1619760501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J HOEKSTRA CEO 208-964-7189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-05-23 |
| Last Update Date | 2025-05-23 |