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General NPI Number Information
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NPI Number | 1689809402
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Entity Type | Organization
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Legal Business Name | PREFERRED CHILD AND FAMILY SERVICES
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 284 MARTIN ST
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City | TWIN FALLS
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State | ID
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Zip | 83301-4542
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Country | US
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Telephone | 208-733-7186
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Fax | 208-733-7178
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Provider Business Mailing Address
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Address Line | 284 MARTIN ST
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City | TWIN FALLS
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State | ID
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Zip | 83301-4542
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Country | US
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Telephone | 208-733-7186
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Fax | 208-733-7178
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Authorized Official
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Title or Position | OWNER
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Name | JASON BEARD
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Credential |
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Telephone | 208-733-7186
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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 | LPC 4078
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License Number State | ID
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