Organization
FAMILY AND CHILDREN'S REHABILITATIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN LEON GIMMESON (OWNER ADMINISTRATOR)
(208) 771-1262
Entity
Organization
Contact information
Practice address
622 W COLLEGE AVE, ST MARIES, ID 83861-1822
(208) 245-4363
(208) 245-4349
Mailing address
622 W COLLEGE AVE, ST MARIES, ID 83861-1822
(208) 245-4363
(208) 245-4349
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/05/2007
Last updated
08/22/2020
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