NPI | 1104665587 |
---|---|
Doing Business As | GUSTAFSON HOUSE |
Entity Type | Organization |
Authorized Contact | SUZANNE BRADY Hr Director/Compliance Officer 208-652-7461 |
Organization Subpart ? | No |
Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
Enumeration Date | 2024-05-23 |
Last Update Date | 2024-05-23 |