| NPI | 1720182926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA VERONICA BLOM Co Owner Business Manager 208-478-2050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-08-22 |