Individual
ALISHA MOSES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
374 FAIRWAY DR, POCATELLO, ID 83201-2011
(208) 339-1265
Mailing address
374 FAIRWAY DR, POCATELLO, ID 83201-2011
(208) 339-1265
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
ID
Other
Enumeration date
05/28/2026
Last updated
05/28/2026
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