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Organization
DEFUNKIFY COUNSELING & CONSULTATION, LLC
Active
Organization
DEFUNKIFY COUNSELING & CONSULTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONCH JAKOVAC (EXECUTIVE DIRECTOR/OWNER)
(208) 971-1053
Entity
Organization
Contact information
Practice address
3484 N BRYCE CANYON PL, MERIDIAN, ID 83646-6061
(208) 971-1054
Mailing address
3484 N BRYCE CANYON PL, MERIDIAN, ID 83646-6061
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
05/23/2021
Last updated
05/23/2021
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