Organization
CHILDREN'S CENTER
Active
Other names
Aspen Developmental Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW FRANCIS SMITH (ADMINISTRATOR)
(208) 534-8303
Entity
Organization
Contact information
Practice address
1820 E 17TH ST STE 330, IDAHO FALLS, ID 83404-6400
(208) 534-8303
(208) 277-2202
Mailing address
3270 E 17TH ST # 261, AMMON, ID 83406-6758
(208) 534-8303
(208) 277-2202
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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