# A NEW LEAF, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** A NEW LEAF
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629492814
- **Legal business name:** A NEW LEAF
- **Authorized official:** DR. BRIAN KEITH CROWNOVER M.D. (VICE PRESIDENT)
- **Authorized official phone:** (208) 695-6355

## Contact information

- **Practice address:** 2548 N STOKESBERRY PL, MERIDIAN, ID 83646-1144
- **Practice address phone:** (208) 695-6355
- **Practice address fax:** (208) 939-5599
- **Mailing address:** 2428 N STOKESBERRY PL, MERIDIAN, ID 83646-5035
- **Mailing address phone:** (208) 695-6355
- **Mailing address fax:** (208) 939-5599

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | LCSW-1080 | ID | — |
| 207Q00000X | Family Medicine Physician | M11819 | ID | Yes |

## Other

- **Enumeration date:** 02/10/2014
- **Last updated:** 02/10/2014