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Organization
ECETERA THERAPY CLINIC
Active
Organization
ECETERA THERAPY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI R MAURER (OWNER)
(208) 709-9215
Entity
Organization
Contact information
Practice address
1070 RIVERWALK DR, IDAHO FALLS, ID 83402-3341
(208) 314-3731
Mailing address
175 E 18TH ST, IDAHO FALLS, ID 83404-6016
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/08/2023
Last updated
02/15/2023
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