| NPI | 1700374766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA CROSS President 208-794-3586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-04-25 |