| NPI | 1679209266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE NICOLE HELTON Lcpc Clinician 208-297-3490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2022-07-27 |
| Last Update Date | 2022-09-28 |