Organization
INTEGRATED FAMILY & COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BRIDGES LCSW (OWNER)
(208) 523-2080
Entity
Organization
Contact information
Practice address
3355 S HOLMES AVE, IDAHO FALLS, ID 83404-7981
(208) 523-2080
(208) 523-2799
Mailing address
3355 S HOLMES AVE, IDAHO FALLS, ID 83404-7981
(208) 523-2080
(208) 523-2799
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCSW1103
ID
101YM0800X
Mental Health Counselor
Primary
LCSW1103
ID
Other
Enumeration date
01/16/2014
Last updated
01/16/2014
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