NPI | 1700512860 |
---|---|
Entity Type | Organization |
Authorized Contact | DARRELL ERIC KEIM Executive Director 208-883-1045 |
Organization Subpart ? | No |
Primary Taxonomy | 175T00000X Peer Specialist |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2022-07-29 |
Last Update Date | 2022-07-29 |