NPI 1477617165
Canyon Creek Developmental Services
Practice location
- Address
- 5214 Cleveland Blvd STE G, Caldwell, ID 83607-8713
- Phone
- (208) 454-6266
- Fax
- (208) 454-6263
Authorised official
- Name
- Beth a Moody
- Title
- Cfo
- Phone
- (208) 454-6266
Registered specialties
Developmentally Disabled Services Day Training Agency
Primary
Registry record
- NPI
- 1477617165
- Entity type
- Organization
- NPI issued
- 20 Dec 2006
- Record last updated
- 22 Aug 2020
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.