| NPI | 1538150081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL J KECK Director Special Services 208-525-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2020-08-22 |