| Restoration Wellness Of Idaho Llc | |
|
3164 E Eastgate Dr Boise ID 83716-5637 | |
| (208) 794-4737 | |
| Not Available |
| Full Name | Restoration Wellness Of Idaho Llc |
|---|---|
| Speciality | Counselor - Pastoral |
| Location | 3164 E Eastgate Dr, Boise, Idaho |
| Authorized Official Name and Position | Melanie Elish Long-azary (OWNER) |
| Authorized Official Contact | 2087944737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoration Wellness Of Idaho Llc Po Box 171362 Boise ID 83717-1362 Ph: (208) 794-4737 | Restoration Wellness Of Idaho Llc 3164 E Eastgate Dr Boise ID 83716-5637 Ph: (208) 794-4737 |
| NPI Number | 1386476380 |
|---|---|
| Provider Enumeration Date | 08/17/2024 |
| Last Update Date | 08/17/2024 |
| Certification Date | 08/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386476380 | NPI | - | NPPES |
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