Organization
EDWISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA DAWN HOUSTON-POWELL ED.S (CO-PRESIDENT)
(208) 308-2410
Entity
Organization
Contact information
Practice address
132 FALLS AVE W, #103, TWIN FALLS, ID 83301-3359
(208) 308-2410
(208) 326-4343
Mailing address
1511 BUSCH CT, TWIN FALLS, ID 83301-3476
(208) 308-2410
(208) 326-4343
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/30/2008
Last updated
07/30/2008
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