Individual provider · Type 1 NPI
Evan White
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Emmett, ID
Practice location
9825 Mayberry Ln
Emmett, ID 83617-3051
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None listed |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1043038268
Evan White's National Provider Identifier is 1043038268, issued on Sep 27, 2024. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Emmett, ID. The record was last updated on Sep 27, 2024.