| NPI | 1306459599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUSTIN HART Director Of Finance 208-664-8119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |