Organization
SUPPORTIVE HOUSING AND INNOVATIVE PARTNERSHIPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH DALE WIDICK LMSW (EXECUTIVE DIRECTOR)
(208) 412-8338
Entity
Organization
Contact information
Practice address
305 E 37TH ST, GARDEN CITY, ID 83714-6419
(208) 331-0900
(208) 331-0904
Mailing address
PO BOX 8803, BOISE, ID 83707-2803
(208) 331-0900
(208) 331-0904
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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