| NPI | 1770647612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S LEE Co Owner 208-559-7773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID 24210) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID 26695) |
| 363LF0000X Nurse Practitioner, Family (Licence: ID 446A) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2010-09-28 |