Organization
C AND R INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VICKI INEZ BAKER (OWNER)
(208) 882-8040
Entity
Organization
Contact information
Practice address
1107 S LOGAN ST, MOSCOW, ID 83843-3124
(208) 882-8040
(208) 882-9050
Mailing address
1107 S LOGAN ST, MOSCOW, ID 83843-3124
(208) 882-8040
(208) 882-9050
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
807128100
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807128100
—
ID
Enumeration date
01/29/2008
Last updated
01/29/2008
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