NPI 1215079777

Idaho Dept of Health & Welfare Esc Region 2

Organisation Case Management Agency Lewiston, ID

Practice location

Address: 2604 16th Ave, Lewiston, ID 83501-3539
Phone: (208) 799-3460
Fax: (208) 799-3466
Mailing address: 1118 F St PO Drawer B, Lewiston, ID 83501-1930

Authorised official

Name: Mary J Jones
Title: Program Manager
Phone: (208) 334-5523

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X

Other Case Management providers in Idaho →

Registry record

NPI: 1215079777
Entity type: Organization
NPI issued: 13 Feb 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.