| 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 |