| NPI | 1548496201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BOWMAN Program D Irector 208-528-7443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: ID RHA-313) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2009-06-08 |