| NPI | 1295729283 |
|---|---|
| Doing Business As | MDC MAGIC VALLEY |
| Entity Type | Organization |
| Authorized Contact | ROB BENNETT Program Director 208-324-6776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251J00000X Nursing Care |
| 251C00000X Day Training, Developmentally Disabled Services (Licence: ID 5mvdev037) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 385H00000X Respite Care | |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2012-01-24 |