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Acquisitions of Businesses, Variable Interest Entities (Details) - USD ($)
$ in Thousands
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Assets and liabilities of the VIEs:          
Total assets $ 1,196,270   $ 1,196,270   $ 1,167,467
Total liabilities 413,827   413,827   408,421
Operating results of the VIEs:          
Net revenue 197,132 $ 168,033 578,264 $ 490,898  
Operating cost:          
Salaries and related costs 116,619 99,835 341,656 289,900  
Rent, supplies, contract labor and other 36,115 29,756 104,086 88,104  
Depreciation and amortization 5,495 4,158 16,776 12,326  
Provision for credit losses 2,073 1,721 5,916 5,065  
Total operating cost 160,260 138,902 468,703 399,504  
Gross profit 36,872 29,131 109,561 91,394  
Other expense 2,455 511 7,054 1,456  
Provision for income taxes 5,233 2,559 14,026 8,781  
Net income 17,642 $ 9,777 48,830 $ 33,106  
Variable Interest Entities [Member]          
Assets and liabilities of the VIEs:          
Total assets 245,300   245,300   231,300
Total liabilities 38,500   38,500   $ 31,900
Operating results of the VIEs:          
Net revenue 22,848   65,771    
Operating cost:          
Salaries and related costs 13,436   39,516    
Rent, supplies, contract labor and other 5,277   13,855    
Depreciation and amortization 1,116   4,030    
Provision for credit losses 228   655    
Total operating cost 20,057   58,056    
Gross profit 2,791   7,715    
Gain on fair value adjustments (764)   (764)    
Other expense 3   9    
Provision for income taxes 11   193    
Net income $ 3,541   $ 8,277