| Firm Fouindations Llc | |
|
2496 Mesa St Idaho Falls ID 83401-3369 | |
| (208) 251-7885 | |
| (208) 745-0527 |
| Full Name | Firm Fouindations Llc |
|---|---|
| Speciality | Psychologist - Rehabilitation |
| Location | 2496 Mesa St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Jesse Peterson (CO-OWNER) |
| Authorized Official Contact | 2082517885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Firm Fouindations Llc 2496 Mesa St Idaho Falls ID 83401-3369 Ph: (208) 251-7885 | Firm Fouindations Llc 2496 Mesa St Idaho Falls ID 83401-3369 Ph: (208) 251-7885 |
| NPI Number | 1821207580 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821207580 | NPI | - | NPPES |
| 8068920 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TR0400X | Psychologist - Rehabilitation | (* (Not Available)) | Primary |
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