| Idaho Youth Ranch | |
|
5465 W Irving St Boise ID 83706-1213 | |
| (208) 377-2613 | |
| Not Available |
| Full Name | Idaho Youth Ranch |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 5465 W Irving St, Boise, Idaho |
| Authorized Official Name and Position | Kimberly Thomas (CFO) |
| Authorized Official Contact | 2083772613 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Youth Ranch 5465 W Irving St Boise ID 83706-1213 Ph: () - | Idaho Youth Ranch 5465 W Irving St Boise ID 83706-1213 Ph: (208) 377-2613 |
| NPI Number | 1952738262 |
|---|---|
| Provider Enumeration Date | 10/01/2013 |
| Last Update Date | 04/06/2023 |
| Certification Date | 04/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952738262 | NPI | - | NPPES |
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