South Fork Services, Llc

LBN: South Fork Services, Llc
South Fork Services, Llc is an health care organization with primary practice located at 310 N 2Nd E Ste 128 , Rexburg ID 83440-1607. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. South Fork Services, Llc can be contacted via phone (208) 356-5675, or through Gordon, Wade via phone (208) 356-5675.

Contact Information

Primary practice address
310 N 2Nd E Ste 128 Rexburg ID 83440-1607
Phone: (208) 356-5675
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gordon, Wade Licensed Clinical Social Worker (LCSW)
Phone: (208) 356-5675

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X LCSW 27205 Idaho

Profile Details

NPI number 1588006217
LBN Legal business name South Fork Services, Llc
DBA Doing business as
Authorized official Gordon, Wade Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 23rd, 2013
Last updated Jul 23rd, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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