Organization
IDAHO CENTER FOR AUTISM, LLC
Active
Organization
IDAHO CENTER FOR AUTISM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE M WHIPPS M.S., M.ED. (EXECUTIVE DIRECTOR)
(208) 342-0374
Entity
Organization
Contact information
Practice address
5353 FRANKLIN RD, BOISE, ID 83705-1112
(208) 342-0374
Mailing address
PO BOX 706, MERIDIAN, ID 83680-0706
(208) 342-0374
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
8078750
ID
Other
Enumeration date
12/10/2007
Last updated
12/10/2007
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