# FAMILY SUBSTITUTES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174035950
- **Authorized official:** AMANDA LACHELLE PEREIRA (OWNER/ WELLNESS DIRECTOR)
- **Authorized official phone:** (208) 308-9183

## Contact information

- **Practice address:** 3797 N 3550 E, KIMBERLY, ID 83341-5093
- **Practice address phone:** (208) 308-9183
- **Mailing address:** 3797 N 3550 E, KIMBERLY, ID 83341-5093
- **Mailing address phone:** (208) 308-9183

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |

## Other

- **Enumeration date:** 11/01/2017
- **Last updated:** 11/01/2017