JEREMY F BLADES

BOISE, ID
NPI1184871816
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID  1139008)
Enumeration Date2008-08-25
Last Update Date2008-08-25
Business Address
-- JEREMY F BLADES CADC
5440 W FRANKLIN RD SUITE 101
BOISE, ID 83705-1079
Phone number: 208-336-9076
Mailing Address
-- JEREMY F BLADES CADC
605 11TH AVE E
GOODING, ID 83330-5368
Phone number: 208-934-8461
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