Organization
CHILDRENS SUPPORTIVE SERVICES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHIE CRANE (SECRETARY-TREASURER)
(208) 524-8996
Entity
Organization
Contact information
Practice address
625 W PACIFIC ST, SUITE 2, BLACKFOOT, ID 83221-2034
(208) 524-8996
(208) 524-1205
Mailing address
1565 E LINCOLN RD, IDAHO FALLS, ID 83401-2129
(208) 524-8996
(208) 524-1205
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807354200
—
ID
Enumeration date
04/23/2007
Last updated
12/02/2009
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