Organization
FAMILY COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI VOLKERS MAED (OWNER)
(208) 233-9709
Entity
Organization
Contact information
Practice address
4960 HAWTHORNE RD, CHUBBUCK, ID 83202-2222
(208) 233-9709
Mailing address
4960 HAWTHORNE RD, CHUBBUCK, ID 83202-2222
(208) 233-9709
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1127
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010144140
REGENCY BLUE SHIELD
ID
01
—
Q1711
BLUE CROSS OF IDAHO
ID
Enumeration date
04/17/2008
Last updated
04/17/2008
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