Organization
EAST IDAHO YOUTH HOMES LLC DDA
Active
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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