| NPI | 1558106344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY BERGER Owner 208-270-1309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2024-09-16 |