| Still Waters Refuge Llc | |
|
1329 Ammon Park Dr Ammon ID 83406-4591 | |
| (208) 569-8599 | |
| Not Available |
| Full Name | Still Waters Refuge Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1329 Ammon Park Dr, Ammon, Idaho |
| Authorized Official Name and Position | Shelby Whiting (OWNER) |
| Authorized Official Contact | 2085698599 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Still Waters Refuge Llc 1329 Ammon Park Dr Ammon ID 83406-4591 Ph: (208) 569-8599 | Still Waters Refuge Llc 1329 Ammon Park Dr Ammon ID 83406-4591 Ph: (208) 569-8599 |
| NPI Number | 1962210328 |
|---|---|
| Provider Enumeration Date | 12/18/2024 |
| Last Update Date | 12/18/2024 |
| Certification Date | 12/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962210328 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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