| NPI | 1801043559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA SFERRA-WATKINS Owner 208-659-5119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCPC-333) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2008-08-25 |