Provider Demographics
NPI:1437201696
Name:ASSOCIATES FOR FAMILY INDEPENDENCE
Entity Type:Organization
Organization Name:ASSOCIATES FOR FAMILY INDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:WADSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:208-390-5858
Mailing Address - Street 1:2588 E 98TH N
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-5475
Mailing Address - Country:US
Mailing Address - Phone:208-390-5858
Mailing Address - Fax:208-552-9999
Practice Address - Street 1:2588 E 98TH N
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-5475
Practice Address - Country:US
Practice Address - Phone:208-390-5858
Practice Address - Fax:208-552-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management