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Organization
METAMORPHOSIS COUNSELING AND HEALTH CENTER OF IDAHO, LLC
Active
Organization
METAMORPHOSIS COUNSELING AND HEALTH CENTER OF IDAHO, LLC
Active
Parent organization
1235791997
Organization subpart
Yes
Provider details
NPI number
Legal business name
1235791997
Authorized official
MRS. CRYSTAL MICHELLE MILLER BS (EXECUTIVE DIRECTOR)
(208) 890-6205
Entity
Organization
Contact information
Practice address
10108 W OVERLAND RD STE A, BOISE, ID 83709-1428
(208) 376-1532
(208) 375-7251
Mailing address
10108 W OVERLAND RD STE A, BOISE, ID 83709-1428
(208) 890-6205
(208) 375-7251
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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