| NPI | 1720797681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK GLEN DURHAM Executive Director 208-861-3196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-11-21 |