Organization
LIFE IMPROVEMENT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB H SILVA (PRESIDENT)
(208) 201-0278
Entity
Organization
Contact information
Practice address
2420 E 25TH ST, SUITE C, IDAHO FALLS, ID 83404-7549
(208) 201-0278
Mailing address
2420 E 25TH ST, SUITE C, IDAHO FALLS, ID 83404-7549
(208) 201-0278
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/01/2010
Last updated
07/01/2010
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