| NPI | 1740586890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BEARD Owner 208-733-7186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: ID NA) |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2024-03-13 |