| NPI | 1962658500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN IRENE SISK Owner / Director 208-771-1551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2008-08-14 |