NPI | 1770105850 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW TYSON HANSEN Owner 208-777-2169 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
163WP0808X Registered Nurse, Psych/Mental Health | |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
104100000X Social Worker | |
Enumeration Date | 2020-05-12 |
Last Update Date | 2024-02-01 |