OrganizationActive
Project Patch
NPI 1457681736 · Emotionally Disturbed Childrens' Residential Treatment Facility · Garden Valley, ID
Provider details
- NPI number
- 1457681736
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Chuck Hagele, Chief Operating Officer(360) 690-8495
- License
- 26124 (ID)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
25 Miracle Ln # 450
Garden Valley, ID 83622-1044
Phone: (208) 462-3074
Fax: (208) 462-3209
Street-level locationGet directions
Mailing address
Po Box 820209
Vancouver, WA 98682-0004
Registry dates
- Enumerated
- 2010-01-08
- Last updated
- 2026-04-28
- Certified
- 2026-04-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.