| 4 The Kids Llc | |
|
845 W Center St Ste C101 Pocatello ID 83204-4205 | |
| (208) 589-1568 | |
| Not Available |
| Full Name | 4 The Kids Llc |
|---|---|
| Speciality | Counselor |
| Location | 845 W Center St Ste C101, Pocatello, Idaho |
| Authorized Official Name and Position | David Wilson (OWNER) |
| Authorized Official Contact | 2085891568 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 4 The Kids Llc 479 Raven Way Apt A Chubbuck ID 83202-1958 Ph: () - | 4 The Kids Llc 845 W Center St Ste C101 Pocatello ID 83204-4205 Ph: (208) 589-1568 |
| NPI Number | 1447013024 |
|---|---|
| Provider Enumeration Date | 02/05/2024 |
| Last Update Date | 02/05/2024 |
| Certification Date | 02/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447013024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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