Provider Demographics
NPI:1740326024
Name:HUMAN SERVICE ALLIANCE
Entity type:Organization
Organization Name:HUMAN SERVICE ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CO ADMIN
Authorized Official - Phone:208-463-4757
Mailing Address - Street 1:1305 2ND ST S STE J
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651
Mailing Address - Country:US
Mailing Address - Phone:208-463-4757
Mailing Address - Fax:208-463-4134
Practice Address - Street 1:1305 2ND ST S STE J
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651
Practice Address - Country:US
Practice Address - Phone:208-463-4757
Practice Address - Fax:208-463-4134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services