Provider Demographics
NPI:1295877371
Name:HIGHROAD HUMAN SERVICES, INC.
Entity type:Organization
Organization Name:HIGHROAD HUMAN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, SECRETARY AND TRESURER
Authorized Official - Prefix:MISS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:208-755-6992
Mailing Address - Street 1:PO BOX 1550
Mailing Address - Street 2:2201 N. GOVERNMENT WAY SUITE B
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83816-1550
Mailing Address - Country:US
Mailing Address - Phone:208-755-6992
Mailing Address - Fax:208-765-7685
Practice Address - Street 1:2201 N GOVERNMENT WAY
Practice Address - Street 2:SUITE B
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-3658
Practice Address - Country:US
Practice Address - Phone:208-667-3118
Practice Address - Fax:208-765-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID805858900Medicaid