Cultivation, Llc | |
211 E. Coeur Dalene Ave. Ste 102 Coeur D'alene ID 83814 | |
(208) 699-6817 | |
(208) 620-2306 |
Full Name | Cultivation, Llc |
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Speciality | Counselor - Professional |
Location | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, Idaho |
Authorized Official Name and Position | Karly Ireland (OFFICE MANAGER/ADMIN SUPERVISOR) |
Authorized Official Contact | 2086996817 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Cultivation, Llc 211 E. Coeur Dalene Ave. Ste 102 Coeur D'alene ID 83814 Ph: (208) 699-6817 | Cultivation, Llc 211 E. Coeur Dalene Ave. Ste 102 Coeur D'alene ID 83814 Ph: (208) 699-6817 |
NPI Number | 1295353217 |
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Provider Enumeration Date | 07/07/2020 |
Last Update Date | 07/07/2020 |
Certification Date | 07/07/2020 |
Identifier | Type | State | Issuer |
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1295353217 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |