Organization
INTRINSIC HOLDINGS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN JOHANSSON (DIRECTOR)
(208) 716-3259
Entity
Organization
Contact information
Practice address
9006 E CEDAR POINT LN, IDAHO FALLS, ID 83401-4834
(208) 716-3259
Mailing address
PO BOX 1672, IDAHO FALLS, ID 83403-1672
(208) 716-3259
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/10/2019
Last updated
04/10/2019
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