| Alliance Family Services, Inc. | |
|
550 Polk St Suite A Twin Falls ID 83301 | |
| (208) 734-9619 | |
| (208) 734-9441 |
| Full Name | Alliance Family Services, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 550 Polk St, Twin Falls, Idaho |
| Authorized Official Name and Position | Stacy Ann Stephens (OWNER) |
| Authorized Official Contact | 2087370572 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Family Services, Inc. 550 Polk St Suite A Twin Falls ID 83301 Ph: (208) 737-0572 | Alliance Family Services, Inc. 550 Polk St Suite A Twin Falls ID 83301 Ph: (208) 734-9619 |
| NPI Number | 1104942218 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 07/25/2018 |
| Medicare PECOS PAC ID | 6800011438 |
|---|---|
| Medicare Enrollment ID | O20140715001440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104942218 | NPI | - | NPPES |
| 805539300 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kathryn Devaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285672378 PECOS PAC ID: 8921041641 Enrollment ID: I20070425000676 |
| Provider Name | Dustin B Tanner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497995088 PECOS PAC ID: 4385780451 Enrollment ID: I20140805000217 |
| Provider Name | Alex B Wills |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649597055 PECOS PAC ID: 1456579564 Enrollment ID: I20140903001666 |
| Provider Name | Karen M Martinat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649468919 PECOS PAC ID: 4183936156 Enrollment ID: I20150703000073 |
| Provider Name | Stacy A Stephens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447692058 PECOS PAC ID: 5395960926 Enrollment ID: I20210121001232 |
| Provider Name | Kristy M Castille |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932768595 PECOS PAC ID: 0345648424 Enrollment ID: I20211004001112 |
| Provider Name | Leah D York |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497257356 PECOS PAC ID: 5799174777 Enrollment ID: I20211112000765 |
| Provider Name | Jean P Espil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326519901 PECOS PAC ID: 9830589332 Enrollment ID: I20211123002581 |
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