NPI 1205623527

49 Alpha a

Organisation Children's Substance Abuse Rehabilitation Facility Jerome, ID

Practice location

Address: 1035 N Lincoln Ave, Jerome, ID 83338-1816
Phone: (208) 308-0158
Mailing address: 1102 Kenyon Rd, Twin Falls, ID 83301-5648

Authorised official

Name: Glen Thorne
Title: President
Phone: (208) 308-0158

Registered specialties (3)

Children's Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 3245S0500X

Other Substance Abuse Rehabilitation Facility providers in Idaho →

Addiction (Substance Use Disorder) Counselor

Behavioral Health & Social Service Providers Taxonomy 101YA0400X

Other Counselor providers in Idaho →

Substance Use Disorder Rehabilitation Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QR0405X

Other Clinic/Center providers in Idaho →

Registry record

NPI: 1205623527
Entity type: Organization
NPI issued: 21 Apr 2025
Record last updated: 9 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.