| NPI | 1689409500 |
|---|---|
| Doing Business As | JC SAFE AND SOBER LIVING FACILITY |
| Entity Type | Organization |
| Authorized Contact | DAREN CLINT LONG Program Manager 208-360-9992 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2024-09-03 |