Organization Name: | CHILDREN'S HOME SOCIETY OF IDAHO |
NPI Number: | 1285971416 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TERESA ALEXANDER (CHEIF EXECUTIVE DIRECTOR) |
Mailing Address: | 740 E Warm Springs Ave Boise |
State: | ID US |
Postal Code: | 837126420 |
Phone Number: | 2083437797 |
Fax Number: | 2083430064 |
NPI Enumeration Date: | 01/08/2013 |
NPI Last Update Date: | 01/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |