| NPI | 1487294310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY A MILLER Administrator 208-713-4603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |