NPI 1043038268

Evan White

Practitioner Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Emmett, ID

Practice location

Address: 9825 Mayberry Ln, Emmett, ID 83617-3051
Phone: (208) 713-1290

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Idaho →

Registry record

NPI: 1043038268
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Sep 2024
Record last updated: 27 Sep 2024

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.