| NPI | 1699092593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD KIETH JOLLIFF Owner/Therapist 208-420-5613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MT LCPC-522) |
| Enumeration Date | 2010-05-01 |
| Last Update Date | 2010-05-01 |