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General NPI Number Information
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NPI Number | 1366593964
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Entity Type | Organization
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Legal Business Name | A TO Z FAMILY SERVICES INC.
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 150 S BROADWAY ST
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City | BLACKFOOT
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State | ID
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Zip | 83221-2711
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Country | US
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Telephone | 208-785-1326
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Fax | 208-785-1396
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Provider Business Mailing Address
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Address Line | 150 S BROADWAY ST
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City | BLACKFOOT
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State | ID
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Zip | 83221-2711
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Country | US
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Telephone | 208-785-1326
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Fax | 208-785-1396
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Authorized Official
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Title or Position | DIRECTOR AND CLINICIAN
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Name | MS. REBECCA JO PERRENOUD
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Credential | LCSW CIBI
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Telephone | 208-785-1326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | DO NOT HAVE ONE
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License Number State | ID
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