| NPI | 1639537012 |
|---|---|
| Doing Business As | MOMENTUM MENTAL AND BEHAVIORAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | MARCUS BOYD OLDER Owner 208-201-8881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID lMSW-32292) |
| Additional Taxonomies | 251B00000X Case Management (Licence: ID LMSW-32292) |
| 251S00000X (Licence: ID LMSW-32292) | |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2016-02-01 |