Organization
WILLARD HOUSE INC
Active
Organization
WILLARD HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MILES LCSW (OWNER)
(208) 339-6565
Entity
Organization
Contact information
Practice address
520 WILLARD AVE, POCATELLO, ID 83201-4537
(208) 339-6565
Mailing address
520 WILLARD AVE, POCATELLO, ID 83201-4537
(208) 339-6565
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
06/01/2020
Last updated
06/01/2020
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