Organization
BANNOCK COUNTY JUVENILE JUSTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT OLSEN MSW (JUVENILE JUSTICE DIRECTOR)
(208) 236-0606
Entity
Organization
Contact information
Practice address
624 E CENTER ST, POCATELLO, ID 83201-6274
(208) 236-0606
(208) 234-1094
Mailing address
624 E CENTER ST, POCATELLO, ID 83201-6274
(208) 236-0606
(208) 234-1094
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
ID
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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