Club, Inc.
NPI #1215097480 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1215097480
- Entity Type
- Organization
- Organization Name
- Club, Inc.
- Primary Specialty
- Voluntary or Charitable
- Enumeration Date
- Dec 11, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2001 S WOODRUFF AVE
- Address 2
- SUITE 6
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-6374
- Phone
- (208) 529-4673
Authorized Official
- Name
- MS. MARDEE HARPER
- Title
- EXECUTIVE DIRECTOR
- Phone
- (208) 529-4673
Specialties & Taxonomy Codes
| Specialty |
|---|
| Voluntary or Charitable |
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