Organization
EXCEPTIONAL CHILD CENTER, INC.
Active
Organization
EXCEPTIONAL CHILD CENTER, INC.
Active
Other names
Center for Independent Living
Organization subpart
No
Provider details
NPI number
Authorized official
RENE STEPHENS (ADMINISTRATOR)
(208) 734-8973
Entity
Organization
Contact information
Practice address
1411 FALLS AVE E, SUITE 703, TWIN FALLS, ID 83301-3455
(208) 734-8973
(208) 734-1075
Mailing address
1411 FALLS AVE E, SUITE 703, TWIN FALLS, ID 83301-3455
(208) 734-8973
(208) 734-1075
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0026238
—
ID
Enumeration date
04/09/2007
Last updated
08/22/2020
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