Provider Demographics
NPI:1881391159
Name:STEWARDS OF RECOVERY SARF
Entity type:Organization
Organization Name:STEWARDS OF RECOVERY SARF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KULOW
Authorized Official - Suffix:
Authorized Official - Credentials:ISAS
Authorized Official - Phone:208-932-4493
Mailing Address - Street 1:685 1ST ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-4003
Mailing Address - Country:US
Mailing Address - Phone:208-932-4493
Mailing Address - Fax:
Practice Address - Street 1:490 EMERALD AVE
Practice Address - Street 2:
Practice Address - City:BLACKFOOT
Practice Address - State:ID
Practice Address - Zip Code:83221-3968
Practice Address - Country:US
Practice Address - Phone:208-932-4493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEWARDS OF RECOVERY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty