Whalio Doctors

NPI 1477617165

Canyon Creek Developmental Services

Organisation Developmentally Disabled Services Day Training Agency Caldwell, ID

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
Agencies Taxonomy 251C00000X Licence 3CANCRK123 (ID)

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.