NPI 1568502409
Idaho Dept of Health & Welfare Itp Region 4
Practice location
- Address
- 1720 Westgate Dr Suite B-2, Boise, ID 83704-7164
- Phone
- (208) 334-0900
- Fax
- (208) 334-0926
Authorised official
- Name
- Mary J Jones
- Title
- Program Manager
- Phone
- (208) 334-5523
Registered specialties (2)
Early Intervention Provider Agency
Primary
Local Education Agency (LEA)
Registry record
- NPI
- 1568502409
- Entity type
- Organization
- NPI issued
- 8 Feb 2007
- Record last updated
- 5 Aug 2013
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.