| NPI | 1104193739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK STEPHENSON Administrator 208-535-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: ID RC-1013) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |