Provider Demographics
NPI:1376103713
Name:IDAHO ANTI-TRAFFICKING COALITION
Entity Type:Organization
Organization Name:IDAHO ANTI-TRAFFICKING COALITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEILINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-630-6601
Mailing Address - Street 1:868 E RIVERSIDE DR STE 170
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-6025
Mailing Address - Country:US
Mailing Address - Phone:208-630-6601
Mailing Address - Fax:208-506-6851
Practice Address - Street 1:925 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2301
Practice Address - Country:US
Practice Address - Phone:208-600-2184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-18
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)