Organization
THE LIVING FARM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN K BAIRD MPA, LSW (PRESIDENT)
(208) 552-9966
Entity
Organization
Contact information
Practice address
373 W HIGHWAY 39 # 2, BLACKFOOT, ID 83221-5600
(208) 709-4538
Mailing address
7079 E PANORAMA DR, IDAHO FALLS, ID 83401-5826
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NOT REQUIRED
ID
Other
Enumeration date
12/19/2006
Last updated
08/22/2020
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