| NPI | 1932499738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY LANGE Director 208-265-8195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| 251C00000X | |
| 251S00000X Community/Behavioral Health | |
| 261Q00000X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |