| NPI | 1962018564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICCOLIA L TANGEN Owner 208-338-4699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2025-07-29 |