Emmett Family Services | |
501 N 16th St Ste 108 & 110 Payette ID 83661-2781 | |
(208) 642-2600 | |
(208) 642-6164 |
Full Name | Emmett Family Services |
---|---|
Speciality | Social Worker - Clinical |
Location | 501 N 16th St, Payette, Idaho |
Authorized Official Name and Position | Michael S Lee (CO-OWNER) |
Authorized Official Contact | 2085597773 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Emmett Family Services 501 N 16th St Ste 108 & 110 Payette ID 83661-2781 Ph: (208) 642-2600 | Emmett Family Services 501 N 16th St Ste 108 & 110 Payette ID 83661-2781 Ph: (208) 642-2600 |
NPI Number | 1770647612 |
---|---|
Provider Enumeration Date | 12/21/2006 |
Last Update Date | 09/28/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770647612 | NPI | - | NPPES |
806575100 | Medicaid | ID | |
806586200 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
104100000X | Social Worker | 26695 (Idaho) | Secondary |
1041C0700X | Social Worker - Clinical | 24210 (Idaho) | Primary |
363LF0000X | Nurse Practitioner - Family | 446A (Idaho) | Secondary |
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