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Individual

RACHAEL A MASAITIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BS

Contact information

Practice address
3515 E ALEXIS CT, NAMPA, ID 83686-5491
(208) 369-0681
Mailing address
3515 E ALEXIS CT, NAMPA, ID 83686-5491
(208) 369-0681

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
CHF-10057
ID

Other

Enumeration date
03/04/2024
Last updated
03/08/2024
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