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Acquisitions of Businesses, Variable Interest Entities (Details) - USD ($)
$ in Thousands
 3 Months Ended 6 Months Ended
Jun. 30, 2025
Jun. 30, 2024
Jun. 30, 2025
Jun. 30, 2024
Dec. 31, 2024
Assets and liabilities of the VIEs:          
Total assets $ 1,179,600   $ 1,179,600   $ 1,167,467
Total liabilities 414,008   414,008   408,421
Operating results of the VIEs:          
Net revenue 197,344 $ 167,190 381,132 $ 322,865  
Operating cost:          
Salaries and related costs 113,788 96,334 225,037 190,065  
Rent, supplies, contract labor and other 34,127 30,335 67,971 58,319  
Depreciation and amortization 5,741 4,299 11,281 8,197  
Provision for credit losses 1,995 1,717 3,843 3,344  
Total operating cost 155,720 133,328 308,443 260,602  
Gross profit 41,624 33,862 72,689 62,263  
Other expense 2,285 772 4,599 944  
Provision for income taxes 4,933 3,083 8,793 6,222  
Net income 17,720 $ 11,712 31,188 $ 23,329  
Variable Interest Entities [Member]          
Assets and liabilities of the VIEs:          
Total assets 242,100   242,100   231,300
Total liabilities 38,100   38,100   $ 31,900
Operating results of the VIEs:          
Net revenue 23,117   42,923    
Operating cost:          
Salaries and related costs 13,175   26,080    
Rent, supplies, contract labor and other 4,461   8,578    
Depreciation and amortization 1,727   2,914    
Provision for credit losses 230   427    
Total operating cost 19,593   37,999    
Gross profit 3,524   4,924    
Other expense 3   6    
Provision for income taxes 182   182    
Net income $ 3,339   $ 4,736