| NPI | 1669709515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRISHA MARIE BORRESEN CEO 208-324-6885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251S00000X | |
| Enumeration Date | 2009-11-13 |
| Last Update Date | 2009-11-13 |