# MEADOR FAMILY THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396612354
- **Authorized official:** JEFFERY RUSSELL MEADOR LAMFT (TREATMENT THERAPIST)
- **Authorized official phone:** (208) 462-4967

## Contact information

- **Practice address:** 916 ALDER CREEK RD., \#272, GARDEN VALLEY, ID 83622-0272
- **Practice address phone:** (208) 462-4967
- **Mailing address:** PO BOX 272, GARDEN VALLEY, ID 83622-0272
- **Mailing address phone:** (208) 462-4967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 10/22/2025
- **Last updated:** 10/22/2025