| NPI | 1184372518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE JOHNSON Treasurer 208-401-1369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2022-07-26 |