Organization
EXCEPTIONAL CHILD CENTER, INC.
Active
Other names
Center for Indpendent Living
Organization subpart
No
Provider details
NPI number
Authorized official
SHIELA J LEMMONS (OFFICE MANAGER)
(208) 734-8973
Entity
Organization
Contact information
Practice address
1411 FALLS AVE E STE 703, TWIN FALLS, ID 83301-3455
(208) 734-8973
(866) 319-5722
Mailing address
1411 FALLS AVE E STE 703, TWIN FALLS, ID 83301-3455
(208) 734-8973
(866) 319-5722
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740303122
—
ID
Enumeration date
10/26/2017
Last updated
06/16/2018
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