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General NPI Number Information
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NPI Number | 1801759378
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH SERVICES CORPORATION
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 117 ASH ST
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City | BELLEVUE
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State | ID
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Zip | 83313-5226
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Country | US
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Telephone | 208-788-4335
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Fax | 208-734-5036
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Provider Business Mailing Address
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Address Line | 794 EASTLAND DR
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City | TWIN FALLS
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State | ID
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Zip | 83301-6856
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Country | US
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Telephone | 208-737-6718
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Fax | 208-734-5036
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Authorized Official
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Title or Position | CFO
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Name | SALMA MIRAMONTES
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Credential |
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Telephone | 208-737-6704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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