Healthcare Provider Details

I. General information

NPI: 1124246582
Provider Name (Legal Business Name): SUSAN CALLS CASE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 D ST SUITE 203
LEWISTON ID
83501-1894
US

IV. Provider business mailing address

11448 LAMPTON VIEW DR
SOUTH JORDAN UT
84095-7814
US

V. Phone/Fax

Practice location:
  • Phone: 208-798-8070
  • Fax: 208-798-8068
Mailing address:
  • Phone: 801-254-8864
  • Fax: 801-254-8864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. HARRY B BELL
Title or Position: DIRECTOR
Credential:
Phone: 801-254-8864