Organization
FAMILY PATHWAYS COOPERATIVE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDEE YOUNG LCSW (ADMINISTRATOR)
(208) 782-1322
Entity
Organization
Contact information
Practice address
3607 POLE LINE RD, POCATELLO, ID 83201-5531
(208) 637-1662
(208) 637-1554
Mailing address
34 LOUELLA ST, BLACKFOOT, ID 83221-1609
(208) 782-1322
(208) 782-1322
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807345000
—
ID
Enumeration date
04/18/2007
Last updated
10/23/2023
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