Organization
AFFIRM HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGEL L JOHNSON (CHIEF ADMIN OFFICER)
(208) 520-2929
Entity
Organization
Contact information
Practice address
2743 E IONA RD, IDAHO FALLS, ID 83401-1343
(208) 520-2929
Mailing address
2743 E IONA RD, IDAHO FALLS, ID 83401-1343
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11481887
BLUE CROSS
ID
05
—
11481887
—
ID
Enumeration date
01/04/2023
Last updated
01/19/2023
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