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Organization

EAST IDAHO YOUTH HOMES LLC DDA

Active
Parent organization
EAST IDAHO YOUTH HOMES LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
EAST IDAHO YOUTH HOMES LLC
Authorized official
KAREN FAYE TORNKVIST (CHIEF ADMINISTRATOR)
(208) 360-8102
Entity
Organization

Contact information

Practice address
983 CURLEW DR, AMMON, ID 83406-4706
(208) 881-9100
Mailing address
550 LINDEN DR, IDAHO FALLS, ID 83401-4149
(208) 360-8102

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician
261QD1600X
Developmental Disabilities Clinic/Center
Primary

Other

Enumeration date
03/14/2023
Last updated
03/14/2023
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