| NPI | 1760286330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MICHELLE MILLER Executive Director And Owner 208-890-6205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Enumeration Date | 2025-04-02 |
| Last Update Date | 2025-04-02 |