Organization
FAMILY HEALTH SERVICES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY BLACKWOOD (CREDENTIALING SPECIALIST)
(208) 737-6718
Entity
Organization
Contact information
Practice address
2647 KIMBERLY RD, TWIN FALLS, ID 83301-7976
(208) 650-7857
(208) 933-4453
Mailing address
794 EASTLAND DR, TWIN FALLS, ID 83301-6856
(208) 734-3312
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
175T00000X
Peer Specialist
—
—
207Q00000X
Family Medicine Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/20/2023
Last updated
06/26/2023
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