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General NPI Number Information
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NPI Number | 1124237367
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Entity Type | Organization
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Legal Business Name | CHILD AND FAMILY RESOURCE
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 316 N 3RD E
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City | REXBURG
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State | ID
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Zip | 83440-1661
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Country | US
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Telephone | 208-356-4911
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Fax | 208-356-5044
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Provider Business Mailing Address
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Address Line | 316 N 3RD E
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City | REXBURG
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State | ID
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Zip | 83440-1661
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Country | US
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Telephone | 208-356-4911
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Fax | 208-356-5044
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Authorized Official
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Title or Position | MANAGER
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Name | JAMES JOHNSTON
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Credential |
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Telephone | 208-356-4911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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