Organization
CHILD FAMILY SOLUTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY WADE L.C.S.W. (CLINICAL DIRECTOR)
(208) 745-0150
Entity
Organization
Contact information
Practice address
137 S STATE ST, RIGBY, ID 83442-1449
(208) 745-0150
Mailing address
137 S STATE ST, RIGBY, ID 83442-1449
(208) 745-0150
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-120
ID
Other
Enumeration date
04/06/2007
Last updated
08/22/2020
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