| NPI | 1245951540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA JOHN WILDING Owner/Operator 208-599-4245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |