NPI 1154543262

Mountain States Group, INC.

Organisation Case Management Agency Boise, ID

Practice location

Address: 1607 W Jefferson St, Boise, ID 83702-5111
Phone: (208) 336-5533
Fax: (208) 947-4290

Authorised official

Name: Hartzell Cobbs
Title: Executive Director
Phone: (208) 336-5533

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X

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Registry record

NPI: 1154543262
Entity type: Organization
NPI issued: 2 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.