| NPI | 1073843868 |
|---|---|
| Doing Business As | MOUNTAIN HOME RTC |
| Entity Type | Organization |
| Authorized Contact | JOHN STUPAK President 267-419-8913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2009-12-30 |
| Last Update Date | 2009-12-30 |