| NPI | 1659014991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE JENSEN Owner 208-339-1756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 251S00000X | |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-04-14 |