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Organization
A NEW LEAF, INC
Active
Organization
A NEW LEAF, INC
Active
Parent organization
A NEW LEAF
Organization subpart
Yes
Provider details
NPI number
Legal business name
A NEW LEAF
Authorized official
DR. BRIAN KEITH CROWNOVER M.D. (VICE PRESIDENT)
(208) 695-6355
Entity
Organization
Contact information
Practice address
2548 N STOKESBERRY PL, MERIDIAN, ID 83646-1144
(208) 695-6355
(208) 939-5599
Mailing address
2428 N STOKESBERRY PL, MERIDIAN, ID 83646-5035
(208) 695-6355
(208) 939-5599
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LCSW-1080
ID
207Q00000X
Family Medicine Physician
Primary
M11819
ID
Other
Enumeration date
02/10/2014
Last updated
02/10/2014
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