| NPI | 1649720558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY CRISTINA KAPPEL Owner/ Clinical Director 208-463-4639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 305S00000X Point of Service | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2018-06-13 |