| Organization Name: | KUNA COUNSELING CENTER, LLC |
| NPI Number: | 1568544047 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JIM A GRIGG (OWNER) |
| Mailing Address: | 190 W Main St Kuna |
| State: | ID US |
| Postal Code: | 83634 |
| Phone Number: | 2089229001 |
| Fax Number: | 2089223778 |
| NPI Enumeration Date: | 10/20/2006 |
| NPI Last Update Date: | 03/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LCPC-407 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |