| Valiant Vitality, L.l.c. | |
|
535 Main Ave St Maries ID 83861-2060 | |
| (559) 907-5116 | |
| Not Available |
| Full Name | Valiant Vitality, L.l.c. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 535 Main Ave, St Maries, Idaho |
| Authorized Official Name and Position | Esther Nelson (OWNER) |
| Authorized Official Contact | 5599075116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Valiant Vitality, L.l.c. Po Box 2018 Post Falls ID 83877-2018 Ph: (559) 907-5116 | Valiant Vitality, L.l.c. 535 Main Ave St Maries ID 83861-2060 Ph: (559) 907-5116 |
| NPI Number | 1598512030 |
|---|---|
| Provider Enumeration Date | 05/02/2024 |
| Last Update Date | 05/02/2024 |
| Certification Date | 05/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598512030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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