# METAMORPHOSIS HEALTH, INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 1407638992
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1720856248
- **Legal business name:** 1407638992
- **Authorized official:** MRS. CRYSTAL MICHELLE MILLER BS (PRESIDENT /CEO)
- **Authorized official phone:** (208) 890-6205

## Contact information

- **Practice address:** 10108 W OVERLAND RD STE A, BOISE, ID 83709-1428
- **Practice address phone:** (208) 376-1532
- **Practice address fax:** (208) 375-7251
- **Mailing address:** 10108 W OVERLAND RD STE A, BOISE, ID 83709-1428
- **Mailing address phone:** (208) 376-1532
- **Mailing address fax:** (208) 375-7251

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 12/14/2023
- **Last updated:** 12/14/2023