Organization
YOUR SUPPORTIVE SERVICES, LLC
Active
Other names
Your Supportive Services
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LOUIS HUML JR. (PARTNER/ADMINISTRATOR)
(208) 339-4902
Entity
Organization
Contact information
Practice address
343 E 4TH N STE 121, REXBURG, ID 83440-6004
(208) 339-4902
Mailing address
PO BOX 341, 343 E 4TH N SUITE 121, REXBURG, ID 83440-0341
(208) 339-4902
(208) 359-0082
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/11/2009
Last updated
07/03/2009
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