| NPI | 1245368224 |
|---|---|
| Other Name | RESIDENTIAL FACILITY |
| Other Name | COMMUNITY BASED COUNSELING |
| Entity Type | Organization |
| Authorized Contact | JENNY SKEELS Business Office Manger 208-743-9404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-2754) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-02-06 |