Ahs of Idaho

NPI #1619119864 in Shoshone, Idaho

Provider Information

NPI Number: 1619119864
Entity Type: Organization
Organization Name: Ahs of Idaho
Primary Specialty: Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date: Apr 2, 2009
Last Updated: Apr 2, 2009

Practice Location

Address: 911 PREACHER CREEK RD
City: Shoshone
State: Idaho
ZIP Code: 83352-5061
Phone: (208) 886-2565

Authorized Official

Name: MS. KATHY REX, CRT
Title: EXECUTIVE DIRECTOR
Phone: (208) 886-2565

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X	Primary

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