| NPI | 1841681806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELLE STAUFFER Lcsw 208-502-0183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ID LCSW 30244) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2015-02-12 |