| NPI | 1023096757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY LYNN SCHOONOVER Administrator 208-934-5601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: ID 38) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2020-08-22 |