| Diversified Social Services, Inc. | |
|
5624 N Government Way Ste 7b Dalton Gardens ID 83815-7350 | |
| (208) 762-9890 | |
| (208) 762-9892 |
| Full Name | Diversified Social Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5624 N Government Way Ste 7b, Dalton Gardens, Idaho |
| Authorized Official Name and Position | Kristina Nicholas Anderson (ADMINISTRATOR) |
| Authorized Official Contact | 2087629890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diversified Social Services, Inc. 5624 N Government Way Ste 7b Dalton Gardens ID 83815-7350 Ph: (208) 762-9890 | Diversified Social Services, Inc. 5624 N Government Way Ste 7b Dalton Gardens ID 83815-7350 Ph: (208) 762-9890 |
| NPI Number | 1720141906 |
|---|---|
| Provider Enumeration Date | 12/18/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720141906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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