| NPI | 1760268791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA REBOLLEDO Owner 208-969-1002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-09-06 |