Human Supports Of Idaho, Inc. | |
314 Badiola St Caldwell ID 83605-4389 | |
(208) 454-8389 | |
(208) 454-8404 |
Full Name | Human Supports Of Idaho, Inc. |
---|---|
Speciality | Community/behavioral Health |
Location | 314 Badiola St, Caldwell, Idaho |
Authorized Official Name and Position | Gregory L Dickerson (ADMINISTRATOR) |
Authorized Official Contact | 2083210160 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Human Supports Of Idaho, Inc. Po Box 820 Caldwell ID 83606-0820 Ph: (208) 454-8389 | Human Supports Of Idaho, Inc. 314 Badiola St Caldwell ID 83605-4389 Ph: (208) 454-8389 |
NPI Number | 1376686915 |
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Provider Enumeration Date | 02/14/2007 |
Last Update Date | 09/30/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376686915 | NPI | - | NPPES |
002800100 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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