| NPI | 1720691249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI ALYSSA STARK Senior Partner 208-867-9403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-27 |