| NPI | 1679257430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALIA SIERRA Co Owner 208-631-5593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2024-03-01 |