MEDICARE: PRECISION 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	251S00000X	Community/Behavioral Health Agency	LPC-3034	ID

General Provider Information

NPI Number	:	1528396884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION SERVICES LLC

Provider Business Mailing Address
First Line	:	3321 S STANFORD ST
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83686-8292
Country	:	US
Telephone Number	:	208-703-9771
Fax Number	:	208-467-9197

Provider Business Practice Location Address
First Line	:	9424 W FAIRVIEW AVE
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83704-8101
Country	:	US
Telephone Number	:	208-375-3888
Fax Number	:	208-375-9444

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CHRISTINE STEPHENSON
Credential	:
Telephone Number	:	208-703-9771

Provider Enumeration Date	:	11/25/2009
Last Update Date	:	11/25/2009

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