Organization
RESTORED PATHS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER ROMERO (OWNER)
(208) 664-8347
Entity
Organization
Contact information
Practice address
109 E HARRISON AVE, COEUR D ALENE, ID 83814-3238
(208) 664-8347
Mailing address
2900 N GOVERNMENT WAY # 136, COEUR D ALENE, ID 83815-3751
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/07/2012
Last updated
11/21/2012
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