| NPI | 1083977656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEATRICE SUSAN CARROLL Executive Director 208-440-7009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: ID LCSW 1159) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2012-06-19 |