| NPI | 1922811157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MARIE MATTIX Substance Use Disorder Counselor 208-615-7599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2025-01-30 |