| NPI | 1952192734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMILA GILLIAM Administrator 208-671-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 104100000X Social Worker | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-05-13 |