Organization
C AND R INCORPORATION
Active
Organization
C AND R INCORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VALERIE SUE CUTSHALL (ADMINISTRATOR)
(208) 882-8040
Entity
Organization
Contact information
Practice address
1107 S LOGAN ST, MOSCOW, ID 83843-3124
(208) 882-8040
(208) 882-9050
Mailing address
1107 S LOGAN ST, MOSCOW, ID 83843-3124
(208) 882-8040
(208) 882-9050
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
8070463
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8070463
—
ID
05
—
8071281
—
ID
Enumeration date
04/03/2007
Last updated
06/23/2008
Update your record
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