| NPI | 1861683724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA BOYD Business Office Manager 208-746-4097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 138) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |