| NPI | 1376007435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCAS J FOWLER President/Executive Director 208-416-9914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-01-23 |