| NPI | 1851448781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN R. KRACKE President 208-743-4680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID Psy189) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |