Organization
BONNEVILLE COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER S CHRISTENSEN (COUNTY COMMISSIONER)
(208) 529-1360
Entity
Organization
Contact information
Practice address
445 N CAPITAL AVE, IDAHO FALLS, ID 83402-3652
(208) 705-5071
(208) 523-5974
Mailing address
605 N CAPITAL AVE, IDAHO FALLS, ID 83402-3582
(208) 705-5071
(208) 523-5974
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
LCSW-24942
ID
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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