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General NPI Number Information
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NPI Number | 1922533520
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Entity Type | Organization
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Legal Business Name | TRU TRANSITIONAL RESOURCES UNITED INC
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Dates
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Enumeration Date | 04/21/2017
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Last Update Date | 04/21/2017
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Provider Practice Location Address
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Address Line | 6639 W HOLLILYNN DR
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City | BOISE
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State | ID
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Zip | 83709-7271
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Country | US
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Telephone | 208-598-8781
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 45474
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City | BOISE
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State | ID
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Zip | 83711-5474
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Country | US
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Telephone | 208-598-8781
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Fax | 208-279-8881
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. RASHEED AMINE RYALS
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Credential |
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Telephone | 325-650-5846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | ID
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Taxonomy #2
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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 | ID
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