South Fork Services, LLC
NPI #1588006217 in Rexburg, Idaho
Provider Information
- NPI Number
- 1588006217
- Entity Type
- Organization
- Organization Name
- South Fork Services, LLC
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jul 23, 2013
- Last Updated
- Jul 23, 2013
Practice Location
Authorized Official
- Name
- WADE GORDON, LCSW
- Title
- OWNER
- Phone
- (208) 356-5675
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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