Healthcare Provider Details

I. General information

NPI: 1053243246
Provider Name (Legal Business Name): SAWTOOTH FAMILY SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 S KIMBALL AVE APT 204
CALDWELL ID
83605-4680
US

IV. Provider business mailing address

1110 S KIMBALL AVE APT 204
CALDWELL ID
83605-4680
US

V. Phone/Fax

Practice location:
  • Phone: 208-515-9923
  • Fax:
Mailing address:
  • Phone: 208-515-9923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY RAE HUST
Title or Position: CASE MANAGER
Credential: BA
Phone: 208-515-9923