| NPI | 1851234975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY MANWARING Managing Member 208-317-9912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2026-04-13 |
| Last Update Date | 2026-04-13 |