Healthcare Provider Details
I. General information
NPI: 1568328706
Provider Name (Legal Business Name): JMJ FAMILY HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
418 S FOREST GLEN BLVD
POST FALLS ID
83854-9622
US
IV. Provider business mailing address
418 S FOREST GLEN BLVD
POST FALLS ID
83854-9622
US
V. Phone/Fax
- Phone: 208-714-9849
- Fax:
- Phone: 208-714-9849
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
JOHN
STRAIN
Title or Position: OWNER
Credential: NP
Phone: 208-714-9849