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General NPI Number Information
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NPI Number | 1740326024
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Entity Type | Organization
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Legal Business Name | HUMAN SERVICE ALLIANCE
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1305 2ND ST S STE J
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City | NAMPA
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State | ID
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Zip | 83651
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Country | US
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Telephone | 208-463-4757
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Fax | 208-463-4134
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Provider Business Mailing Address
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Address Line | 1305 2ND ST S STE J
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City | NAMPA
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State | ID
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Zip | 83651
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Country | US
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Telephone | 208-463-4757
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Fax | 208-463-4134
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Authorized Official
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Title or Position | CO ADMIN
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Name | MRS. CHRIS JOHNSON
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Credential | CO ADMIN
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Telephone | 208-463-4757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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