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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