| NPI | 1376340893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN FAYE TORNKVIST Owner 208-360-8102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-03-03 |