| NPI | 1922392869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY LYNN RICHARDSON Operations Director 208-242-3771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: ID LCSW-28906) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCSW-28906) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2011-08-24 |