| NPI | 1992502827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENA SCHILDHAUER Owner 208-286-1529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-02-27 |
| Last Update Date | 2025-02-27 |