| Active Community Solutions, Llc | |
|
101 W 18th St Burley ID 83318-2422 | |
| (661) 458-6611 | |
| Not Available |
| Full Name | Active Community Solutions, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 101 W 18th St, Burley, Idaho |
| Authorized Official Name and Position | David Esqueda Tovar (OWNER) |
| Authorized Official Contact | 6614586611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Community Solutions, Llc 101 W 18th St Burley ID 83318-2422 Ph: (661) 458-6611 | Active Community Solutions, Llc 101 W 18th St Burley ID 83318-2422 Ph: (661) 458-6611 |
| NPI Number | 1881423531 |
|---|---|
| Provider Enumeration Date | 07/31/2024 |
| Last Update Date | 07/31/2024 |
| Certification Date | 07/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881423531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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