| Family Pathways Cooperative, Inc | |
|
34 Louella St Blackfoot ID 83221-1609 | |
| (208) 782-1322 | |
| (208) 782-1322 |
| Full Name | Family Pathways Cooperative, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 34 Louella St, Blackfoot, Idaho |
| Authorized Official Name and Position | Sandee Young (PRESIDENT) |
| Authorized Official Contact | 2087821322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Pathways Cooperative, Inc 34 Louella St Blackfoot ID 83221-1609 Ph: (208) 782-1322 | Family Pathways Cooperative, Inc 34 Louella St Blackfoot ID 83221-1609 Ph: (208) 782-1322 |
| NPI Number | 1336365097 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336365097 | NPI | - | NPPES |
| 805060200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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