| NPI | 1467979153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY O'BRIEN Owner/Director 208-476-7483 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2017-08-24 |