Organization
THE LILYPAD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW S WARD (PRESIDENT)
(208) 546-9723
Entity
Organization
Contact information
Practice address
2010 W ROSTEN AVE, NAMPA, ID 83686-4854
(208) 546-9723
(866) 308-7175
Mailing address
PO BOX 1593, NAMPA, ID 83653-1593
(208) 546-9723
(866) 308-7175
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
DDA-1341
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A0000393
—
ID
Enumeration date
02/11/2011
Last updated
02/11/2011
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