# JOURNEY HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wellness and Aesthetics Clinic of Idaho
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063143659
- **Authorized official:** ALEXANDRIA MWANGA DNP, FNP-C (MEDICAL DIRECTOR)
- **Authorized official phone:** (208) 380-9906

## Contact information

- **Practice address:** 1965 S EAGLE RD STE 180, MERIDIAN, ID 83642-9246
- **Practice address phone:** (986) 666-3866
- **Practice address fax:** (986) 666-3038
- **Mailing address:** 1965 S EAGLE RD STE 180, MERIDIAN, ID 83642-9246
- **Mailing address phone:** (986) 666-3866
- **Mailing address fax:** (986) 666-3038

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171400000X | Health & Wellness Coach | — | NULL | — |
| 171400000X | Health & Wellness Coach | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2022
- **Last updated:** 12/20/2024