Organization
EXCEPTIONAL CHILD CENTER, INC.
Active
Other names
Center for Independent Living
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENE STEPHENS (ADMINISTRATOR)
(208) 734-8973
Entity
Organization
Contact information
Practice address
1411 FALLS AVE E STE 703, TWIN FALLS, ID 83301-3455
(208) 734-8973
(208) 734-1075
Mailing address
1411 FALLS AVE E STE 703, TWIN FALLS, ID 83301-3455
(208) 734-8973
(208) 734-1075
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
5CIL019
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8068649
—
ID
Enumeration date
01/16/2009
Last updated
01/16/2009
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