Organization
FAMILY PATHWAYS COOPERATIVE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDEE K. YOUNG LCSW (ADMINISTRATOR)
(208) 782-1322
Entity
Organization
Contact information
Practice address
34 LOUELLA ST, BLACKFOOT, ID 83221-1609
(208) 782-1322
(208) 782-1322
Mailing address
34 LOUELLA ST, BLACKFOOT, ID 83221-1609
(208) 782-1322
(208) 782-1322
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804102000
—
ID
Enumeration date
08/11/2006
Last updated
10/23/2023
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