Mountain West Supportive Services
NPI #1114417029 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1114417029
- Entity Type
- Organization
- Organization Name
- Mountain West Supportive Services
- Primary Specialty
- Clinic/Center - Mental Health (Including Community Mental Health Center)
- Enumeration Date
- May 16, 2018
- Last Updated
- May 16, 2018
Practice Location
- Address
- 1970 E 17TH ST STE 101
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-8046
- Phone
- (208) 715-0218
Authorized Official
- Name
- KALLE STEPHANIE SMITH, LSW
- Title
- OWNER
- Phone
- (208) 715-0218
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Management |
| Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center) |
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