Organization
FAMILY HEALTH SERVICES CORPORATION
Active
Other names
FAMILY HEALTH SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY BLACKWOOD (CREDENTIALING SPECIALIST)
(208) 737-6718
Entity
Organization
Contact information
Practice address
651 S BEVERLY ST, SHOSHONE, ID 83352
(208) 886-2224
(208) 886-2634
Mailing address
794 EASTLAND DR, TWIN FALLS, ID 83301-6856
(208) 737-6718
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
1223G0001X
General Practice Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
183500000X
Pharmacist
—
—
207Q00000X
Family Medicine Physician
—
—
208U00000X
Clinical Pharmacology Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/12/2022
Last updated
10/28/2024
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