NPI 1619119864

Ahs of Idaho

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Shoshone, ID

Practice location

Address: 911 Preacher Creek Rd, Shoshone, ID 83352-5061
Phone: (208) 886-2565
Fax: (208) 886-2153

Authorised official

Name: Kathy Rex
Title: Executive Director
Phone: (208) 886-2565

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 25860 (ID)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Idaho →

Registry record

NPI: 1619119864
Entity type: Organization
NPI issued: 2 Apr 2009
Record last updated: 2 Apr 2009

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.