NPI age
5 years
Enumerated 2020-07-16
Across 319 active case manager/care coordinator providers in Idaho.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | AD005757R | DRIVERS LICENSE |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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