Organization
EMMETT FAMILY SERVICES, LLC
Active
Other names
Payette Family Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S LEE LCSW (CO-OWNER)
(208) 365-5445
Entity
Organization
Contact information
Practice address
2007 E QUAIL RUN RD, SUITE 1, EMMETT, ID 83617-5059
(208) 365-5445
(208) 365-6226
Mailing address
2007 E QUAIL RUN RD, SUITE 1, EMMETT, ID 83617-5059
(208) 365-5445
(208) 365-6226
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
NA
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806575100
—
ID
05
—
806582400
—
ID
05
—
806586200
—
ID
05
—
806598900
—
ID
05
—
807346400
—
ID
05
—
807360700
—
ID
05
—
807378100
—
ID
Enumeration date
11/07/2006
Last updated
09/28/2010
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