| NPI | 1700084290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORIE SUE COOK Mental Health Therapist 208-461-3720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCSW562) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-08-22 |