Organization
IDAHO CENTER FOR AUTISM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE WHIPPS (EXECUTIVE DIRECTOR)
(208) 342-0374
Entity
Organization
Contact information
Practice address
200 S PHILLIPPI ST, BOISE, ID 83705-1152
(208) 342-0374
Mailing address
200 S PHILLIPPI ST, BOISE, ID 83705-1152
(208) 342-0374
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
3CSA146
ID
Other
Enumeration date
05/14/2007
Last updated
08/22/2020
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