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Organization

DIVERSIFIED SOCIAL SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KRISTINA NICHOLAS LSW (PROGRAM MANAGER/PRESIDENT)
(208) 762-9890
Entity
Organization

Contact information

Practice address
6640 N GOVT WAY, SUITE B, DALTON GARDENS, ID 83815-8702
(208) 762-9890
(208) 762-9892
Mailing address
6640 N GOVT WAY, SUITE B, DALTON GARDENS, ID 83815-8702
(208) 762-9890
(208) 762-9892

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
09/06/2005
Last updated
08/22/2020
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