Kelly Companies, LLC
Social Worker, Clinical in Donnelly, ID. Organization (NPI-2).
NPI number1487310074
StatusActive
Last updated in NPPESNov 9, 2021
Details
- NPI
- 1487310074
- Entity type
- Organization (NPI-2)
- Legal business name
- Kelly Companies, LLC
- Organization subpart
- Yes
- Enumeration date
- Nov 9, 2021
- Certification date
- Nov 9, 2021
- Last updated
- Nov 9, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Other names
- Mountain Valley Counseling & Outdoor Therapy (Doing Business As)
Practice location
13019 Ponderosa DrDonnelly, ID 83615
Phone 208-880-8727
Mailing address
Po Box 416Donnelly, ID 83615-0416
Phone 208-880-8727
Authorized official
Jamie Tisa Coffey-Kelly
President/Ceo
2088808727
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