OrganizationActive
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NPI 1205623527 · Children's Substance Abuse Rehabilitation Facility · Jerome, ID
Provider details
- NPI number
- 1205623527
- Entity type
- Organization
- Primary specialty
- Children's Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Authorized official
- Glen Thorne, President
Mailing address
1102 Kenyon Rd
Twin Falls, ID 83301-5648
Registry dates
- Enumerated
- 2025-04-21
- Last updated
- 2025-09-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.