| The Living Farm, Pc | |
|
373 W Highway 39 # 2 Blackfoot ID 83221-5600 | |
| (208) 709-4538 | |
| Not Available |
| Full Name | The Living Farm, Pc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 373 W Highway 39 # 2, Blackfoot, Idaho |
| Authorized Official Name and Position | John K Baird (PRESIDENT) |
| Authorized Official Contact | 2085529966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Living Farm, Pc 7079 E Panorama Dr Idaho Falls ID 83401-5826 Ph: () - | The Living Farm, Pc 373 W Highway 39 # 2 Blackfoot ID 83221-5600 Ph: (208) 709-4538 |
| NPI Number | 1316000441 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316000441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | NOT REQUIRED (Idaho) | Primary |
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