| NPI | 1558106344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ANDERSON Owner 208-821-7410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2026-06-10 |