Organization
AMAZING ASSESSMENTS & EXCEPTIONAL EVALUATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA JOHN WILDING CADC (OWNER/OPERATOR)
(208) 599-4245
Entity
Organization
Contact information
Practice address
5732 W DURNING DR, EAGLE, ID 83616-6238
(208) 599-4245
Mailing address
5732 W DURNING DR, EAGLE, ID 83616-6238
(208) 599-4245
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15684190
—
ID
Enumeration date
09/06/2022
Last updated
09/06/2022
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