Organization
NORTHFORK DEVELOPMENTAL SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID R PARKE (PRESIDENT)
(208) 624-7781
Entity
Organization
Contact information
Practice address
104 N BRIDGE ST, SUITE #117, SAINT ANTHONY, ID 83445
(208) 624-7781
(208) 624-7742
Mailing address
PO BOX 532, SAINT ANTHONY, ID 83445
(208) 624-7781
(208) 624-7742
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
7NRTHF030
ID
Other
Enumeration date
03/19/2007
Last updated
08/22/2020
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