| Your Supportive Services | |
|
343 E 4th N Ste 121 Rexburg ID 83440-6004 | |
| (208) 339-4902 | |
| Not Available |
| Full Name | Your Supportive Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 343 E 4th N Ste 121, Rexburg, Idaho |
| Authorized Official Name and Position | James Louis Huml (PARTNER/ADMINISTRATOR) |
| Authorized Official Contact | 2083394902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Supportive Services Po Box 341 343 E 4th N Suite 121 Rexburg ID 83440-0341 Ph: (208) 339-4902 | Your Supportive Services 343 E 4th N Ste 121 Rexburg ID 83440-6004 Ph: (208) 339-4902 |
| NPI Number | 1316188964 |
|---|---|
| Provider Enumeration Date | 03/11/2009 |
| Last Update Date | 07/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316188964 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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