| NPI | 1730121195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY M MCEVILLY Director 208-336-4504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCSW830) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID NP458A) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-08-22 |