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Organization
COPACETIC SUPPORTED LIVING
Active
Organization
COPACETIC SUPPORTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RILEY CASTILLO (OWNER/OPERATOR)
(208) 297-0811
Entity
Organization
Contact information
Practice address
540 S 16TH ST STE 112, PAYETTE, ID 83661-3514
(208) 297-0811
Mailing address
540 S 16TH ST STE 112, PAYETTE, ID 83661-3514
(208) 297-0811
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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