| NPI | 1811292915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BOWMAN Program Director 208-346-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: ID RHA-2498) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |