Graduated: 2013
NPI: 1679997779
Practice Locations (3)
COMMUNITY COUNCIL OF IDAHO, INC.
1491 PKWY DR
BLACKFOOT, ID 832211667
2087820500
COMMUNITY COUNCIL OF IDAHO, INC.
2088 E 25TH ST
IDAHO FALLS, ID 834046490
COMMUNITY COUNCIL OF IDAHO, INC.
2100 ALAN ST
IDAHO FALLS, ID 834045801
2085287655
Source: CMS National Downloadable File, September 2026.