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ALCOHOLISM INTERVENTION SERVICES

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Company Details

Name: ALCOHOLISM INTERVENTION SERVICES
Jurisdiction: Idaho
Legal type: Assumed Business Name
Status: Active-Current
Date of registration: 25 Jan 2000 (25 years ago)
Entity Number: 110111
Place of Formation: IDAHO
File Number: 0000110111
ZIP code: 83706
County: Ada County
Mailing Address: 4477 EMERALD STE A-200 BOISE, ID 83706

National Provider Identifier

NPI Number:
1265879548

Authorized Person:

Name:
MR. TED WENZEL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

Fax:
2083385579

Filing

Filing Name Filing Number Filing date
Initial Filing 0000110111 2000-01-25

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Date of last update: 23 Sep 2024

Sources: Idaho Secretary of State