| NPI | 1982040135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTOPHER LEON WALTON Owner/President 208-403-0135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW 1311) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2013-05-15 |