Organization
GEM STATE DEVELOPMENTAL CENTER LLC
Active
Parent organization
SYRINGA SOCIAL SERVICES LLC
Other names
Gem State Developmental Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SYRINGA SOCIAL SERVICES LLC
Authorized official
MS. LORI JO POOLE LCSW (CLINICAL DIRECTOR)
(208) 888-5566
Entity
Organization
Contact information
Practice address
818 NW 15TH ST, MERIDIAN, ID 83642-3724
(208) 888-5566
(208) 888-5578
Mailing address
818 NW 15TH ST, MERIDIAN, ID 83642-3724
(208) 888-5566
(208) 888-5578
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
09/06/2019
Last updated
09/06/2019
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