| Lake Counseling Services, Llc | |
|
620 S Idaho Ave Fruitland ID 83619-2607 | |
| (208) 739-6121 | |
| Not Available |
| Full Name | Lake Counseling Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 620 S Idaho Ave, Fruitland, Idaho |
| Authorized Official Name and Position | Christa Lake (OWNER) |
| Authorized Official Contact | 2087396121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Counseling Services, Llc 2719 Dogwood Ave Fruitland ID 83619-5067 Ph: (208) 739-6121 | Lake Counseling Services, Llc 620 S Idaho Ave Fruitland ID 83619-2607 Ph: (208) 739-6121 |
| NPI Number | 1861262651 |
|---|---|
| Provider Enumeration Date | 01/03/2024 |
| Last Update Date | 01/03/2024 |
| Certification Date | 01/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861262651 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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