| NPI | 1740303239 |
|---|---|
| Other Name | BITTERROOT HOME |
| Entity Type | Organization |
| Authorized Contact | RENE STEPHENS Administrator 208-734-8973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |