Organization
FAMILY PRACTICE MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM C AHLRICHS LCSW (SOCIAL WORKER)
(208) 367-6030
Entity
Organization
Contact information
Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 367-6030
Mailing address
6318 BERMUDA DR, BOISE, ID 83709-1009
(208) 378-0070
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW-24633
ID
Other
Enumeration date
04/04/2007
Last updated
08/22/2020
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