| Mountain States Group, Inc | |
|
1607 W Jefferson St Boise ID 83702-5111 | |
| (208) 336-5533 | |
| (208) 336-0880 |
| Full Name | Mountain States Group, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 1607 W Jefferson St, Boise, Idaho |
| Authorized Official Name and Position | Hartzell Cobbs (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2083365533 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain States Group, Inc 1607 W Jefferson St Boise ID 83702-5111 Ph: (208) 336-5533 | Mountain States Group, Inc 1607 W Jefferson St Boise ID 83702-5111 Ph: (208) 336-5533 |
| NPI Number | 1225258007 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225258007 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | LSW2214 (Idaho) | Primary |
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