Metamorphosis Counseling And Health Center Of Idaho, LLC
Peer Specialist in Boise, ID. Organization (NPI-2).
NPI number1043088511
StatusActive
Last updated in NPPESDec 14, 2023
Details
- NPI
- 1043088511
- Entity type
- Organization (NPI-2)
- Legal business name
- Metamorphosis Counseling And Health Center Of Idaho, LLC
- Organization subpart
- Yes
- Enumeration date
- Dec 14, 2023
- Certification date
- Dec 14, 2023
- Last updated
- Dec 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | – | Yes |
Practice location
10108 W Overland Rd Ste ABoise, ID 83709-1428
Phone 208-376-1532 · Fax 208-375-7251
Mailing address
10108 W Overland Rd Ste ABoise, ID 83709-1428
Phone 208-890-6205 · Fax 208-375-7251
Authorized official
Crystal Michelle Miller
Executive Director
2088906205
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