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General NPI Number Information
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NPI Number | 1265649503
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Entity Type | Organization
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Legal Business Name | FAMILIES UNITED NETWORK
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 1512 RED CEDAR RD
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City | REXBURG
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State | ID
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Zip | 83440
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Country | US
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Telephone | 208-351-0649
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Fax | 208-656-8830
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Provider Business Mailing Address
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Address Line | 1512 RED CEDAR RD
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City | REXBURG
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State | ID
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Zip | 83440
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Country | US
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Telephone | 208-351-0649
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Fax | 208-656-8830
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Authorized Official
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Title or Position | AGENCY OWNER
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Name | MRS. LARAINE MCDONELL
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Credential | B.S.
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Telephone | 208-656-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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