NPI 1316984529 · live from the CMS NPI Registry
Family Health Services Corporation
Clinic/Center, Federally Qualified Health Center (FQHC) in Fairfield, ID. National Provider Identifier 1316984529, active.
NPI record
| NPI | 1316984529 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Federally Qualified Health Center (FQHC) 261QF0400X |
| Practice location | 401 W Camas Ave, Fairfield, ID 83327 |
| Practice phone | 208-764-2677 |
| Mailing address | 794 Eastland Dr, Twin Falls, ID 83301 |
| Enumerated | May 31, 2006 |
| Last updated | April 30, 2021 |
| Authorized official | Aaron Houston, Cfo |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical | 1041C0700X | — |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Counselor, Mental Health | 101YM0800X | — |
| Psychologist | 103T00000X | — |
| Psychologist, Cognitive & Behavioral | 103TB0200X | — |
| Marriage & Family Therapist | 106H00000X | — |
| Dentist | 122300000X | — (ID) |
| Dental Hygienist | 124Q00000X | — (ID) |
| Dietitian, Registered | 133V00000X | — (ID) |
| Family Medicine | 207Q00000X | — (ID) |
| Physician Assistant | 363A00000X | — (ID) |
| Nurse Practitioner | 363L00000X | — (ID) |
| Clinic/Center, Federally Qualified Health Center (FQHC) primary | 261QF0400X | — (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.