Kelly Companies, Llc | |
13019 Ponderosa Dr Donnelly ID 83615 | |
(208) 880-8727 | |
Not Available |
Full Name | Kelly Companies, Llc |
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Speciality | Social Worker - Clinical |
Location | 13019 Ponderosa Dr, Donnelly, Idaho |
Authorized Official Name and Position | Jamie Tisa Coffey-kelly (PRESIDENT/CEO) |
Authorized Official Contact | 2088808727 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Kelly Companies, Llc Po Box 416 Donnelly ID 83615-0416 Ph: (208) 880-8727 | Kelly Companies, Llc 13019 Ponderosa Dr Donnelly ID 83615 Ph: (208) 880-8727 |
NPI Number | 1487310074 |
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Provider Enumeration Date | 11/09/2021 |
Last Update Date | 11/09/2021 |
Certification Date | 11/09/2021 |
Identifier | Type | State | Issuer |
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1487310074 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |