Organization
LIVING RESOURCES OF IDAHO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA SAUER (EXECUTIVE DIRECTOR/ADMINISTRATOR)
(208) 616-0060
Entity
Organization
Contact information
Practice address
5571 N GLENWOOD ST, GARDEN CITY, ID 83714-1336
(208) 616-0060
Mailing address
5571 N GLENWOOD ST, GARDEN CITY, ID 83714-1336
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
W192684
ID
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/02/2018
Last updated
11/13/2019
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