| NPI | 1134562648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN ISAAC Administrator 208-267-0260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: ID RC 1044) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2023-11-06 |