| NPI | 1811338148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHONNE LEE PIEKMSA Owner 208-455-1788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 151) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: ID lpc-5173) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2021-04-14 |