| NPI | 1962263897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSEMARY LADACY LUQUE Business Owner/Provider 208-863-1404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2024-02-02 |