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1083480404
LUCAS SMITH
BLACKFOOT, ID
NPI
1083480404
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities
Enumeration Date
2023-11-27
Last Update Date
2023-11-27
Business Address
LUCAS SMITH
861 LAKESIDE DR
BLACKFOOT, ID 83221-1674
Phone number: 208-360-7355
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Mailing Address
LUCAS SMITH
861 LAKESIDE DR
BLACKFOOT, ID 83221-1674
Phone number:
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