Organization
FAMILY HEALTH SERVICES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY BLACKWOOD (CREDENTIALING SPECIALIST)
(208) 737-6718
Entity
Organization
Contact information
Practice address
61 E HIGHWAY 24, SHOSHONE, ID 83352-5338
(208) 886-2381
Mailing address
794 EASTLAND DR, TWIN FALLS, ID 83301-6856
(208) 735-9363
(208) 734-3313
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
—
—
104100000X
Social Worker
—
—
1041S0200X
School Social Worker
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/06/2021
Last updated
10/06/2021
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