NPI 1689718520

Canyon Creek Developmental Services

Organisation Local Education Agency (LEA) Caldwell, ID

Practice location

Address: 5214 Cleveland Blvd STE G, Caldwell, ID 83607-8713
Phone: (208) 454-6266
Fax: (208) 454-6431

Authorised official

Name: Beth a Moody
Title: Cfo
Phone: (208) 454-6266

Registered specialties

Local Education Agency (LEA) Primary

Agencies Taxonomy 251300000X Licence 3CANCRK123 (ID)

Other Local Education Agency (LEA) providers in Idaho →

Registry record

NPI: 1689718520
Entity type: Organization
NPI issued: 16 Feb 2007
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.