| NPI | 1093794703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY CHARLES CRUMRINE Executive Director 208-734-4112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services (Licence: ID 5MVRS020) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2020-08-22 |