| NPI | 1598975658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONNA J. SMITH Administrator 208-529-8526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-06-02 |