Organization
ADVANCED SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY LOUISE GUSMAN (OWNER)
(208) 461-0438
Entity
Organization
Contact information
Practice address
210 E CAROL ST, NAMPA, ID 83687-3820
(208) 461-0438
Mailing address
210 E CAROL ST, NAMPA, ID 83687-3820
(208) 461-0438
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806263500
—
ID
05
—
806275900
—
ID
Enumeration date
03/19/2007
Last updated
07/21/2022
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