Organization
AGENCY FOR CULTURAL ALLIANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACEY ANN MARTINEZ BS,CPRP (LLC MEMBER/MANAGER)
(208) 407-1857
Entity
Organization
Contact information
Practice address
1655 W FAIRVIEW AVE STE 103, BOISE, ID 83702-5173
(208) 407-1857
(208) 906-8637
Mailing address
1655 W FAIRVIEW AVE STE 103, BOISE, ID 83702-5173
(208) 407-1857
(208) 906-8637
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/11/2013
Last updated
08/19/2013
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