| NPI | 1235758897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA ELIZABETH TADLOCK COO 208-255-9460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |