| NPI | 1992663744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MAUST Owner Practictioner 208-789-6826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-01-12 |
| Last Update Date | 2026-03-06 |