MEDICARE: SAWTOOTH FAMILY SUPPORT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1053243246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAWTOOTH FAMILY SUPPORT SERVICES LLC

Provider Business Mailing Address
First Line	:	1110 S KIMBALL AVE APT 204
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-4680
Country	:	US
Telephone Number	:	208-515-9923
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 S KIMBALL AVE APT 204
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-4680
Country	:	US
Telephone Number	:	208-515-9923
Fax Number	:

Authorized Official
Title or Position	:	CASE MANAGER
Name	:	ASHLEY RAE HUST
Credential	:	BA
Telephone Number	:	208-515-9923

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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