Project Patch
NPI #1457681736 in Garden Valley, Idaho
Provider Information
- NPI Number
- 1457681736
- Entity Type
- Organization
- Organization Name
- Project Patch
- Primary Specialty
- Psychiatric Residential Treatment Facility
- Enumeration Date
- Jan 8, 2010
- Last Updated
- Jan 8, 2010
Practice Location
- Address
- 25 MIRACLE LN
- City
- Garden Valley
- State
- Idaho
- ZIP Code
- 83622
- Phone
- (208) 462-3074
Authorized Official
- Name
- CHUCK A HAGELE
- Title
- CHIEF OPERATING OFFICER
- Phone
- (360) 690-8495
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatric Residential Treatment Facility |
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