Organization
HOME AGAIN ICF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER LYN DAVIS (ADMINISTRATOR)
(208) 863-1846
Entity
Organization
Contact information
Practice address
2311 E ARUBA AVE, NAMPA, ID 83686-1292
(208) 461-3203
(208) 461-3203
Mailing address
2311 ARUBA DR, NAMPA, ID 83686
(208) 461-3203
(208) 461-3203
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
78
ID
Other
Enumeration date
09/25/2009
Last updated
09/25/2009
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