| NPI | 1235997651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER ORAM Administrator 208-921-4458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-03-27 |