| NPI | 1073375374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIERRA E REGALADO Executive Director 208-697-3845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-01-23 |