| NPI | 1336998921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS PAUL DONALDSON President 208-861-5609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2024-05-15 |