Child And Family Resource
Clinic/Center, Rehabilitation in Rexburg, ID. Organization (NPI-2).
NPI number1124237367
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1124237367
- Entity type
- Organization (NPI-2)
- Legal business name
- Child And Family Resource
- Organization subpart
- No
- Enumeration date
- May 22, 2007
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0400X | Clinic/Center, Rehabilitation | – | – | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – |
Practice location
316 N 3rd ERexburg, ID 83440-1661
Phone 208-356-4911 · Fax 208-356-5044
Mailing address
316 N 3rd ERexburg, ID 83440-1661
Phone 208-356-4911 · Fax 208-356-5044
Authorized official
James Johnston
Manager
2083564911
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