Organization Name: | CHILD AND FAMILY RESOURCE |
NPI Number: | 1124237367 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES JOHNSTON (MANAGER) |
Mailing Address: | 316 N 3rd E Rexburg |
State: | ID US |
Postal Code: | 834401661 |
Phone Number: | 2083564911 |
Fax Number: | 2083565044 |
NPI Enumeration Date: | 05/22/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |