| NPI | 1912182163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA CALDERWOOD Owner/Manager 208-552-9174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-27801) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: ID LCSW-27801) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2023-02-05 |