Provider Demographics
NPI:1346061777
Name:SAFE RELEASE HOUSE
Entity type:Organization
Organization Name:SAFE RELEASE HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:RICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-919-7610
Mailing Address - Street 1:8154 W PACKSADDLE DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-4964
Mailing Address - Country:US
Mailing Address - Phone:208-919-7610
Mailing Address - Fax:
Practice Address - Street 1:8154 W PACKSADDLE DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-4964
Practice Address - Country:US
Practice Address - Phone:208-919-7610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit