Organization
A REFERRAL & INFORMATION SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS BRENDA ELAINE DEGNER (OFFICE MANAGER)
(208) 733-0443
Entity
Organization
Contact information
Practice address
1537 ADDISON AVE E, TWIN FALLS, ID 83301-5342
(208) 733-0443
(208) 735-1375
Mailing address
1537 ADDISON AVE E, TWIN FALLS, ID 83301-5342
(208) 733-0443
(208) 735-1375
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807669900
—
ID
05
—
807675400
—
ID
Enumeration date
04/20/2007
Last updated
05/20/2008
Update your record
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