Organization
HAWKS LANDING OF IDAHO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SARA ELIZABETH TADLOCK (COO)
(208) 255-9460
Entity
Organization
Contact information
Practice address
222 NIGHTHAWK RD, BONNERS FERRY, ID 83805-5441
(208) 946-7005
Mailing address
222 NIGHTHAWK RD, BONNERS FERRY, ID 83805-5441
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/14/2020
Last updated
04/14/2020
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