Organization
PENNYFARTHING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY LOUKUS M.S. (OWNER)
(208) 255-1617
Entity
Organization
Contact information
Practice address
520 CEDAR ST, STE A, SANDPOINT, ID 83864-1569
(208) 255-1617
Mailing address
520 CEDAR ST, STE A, SANDPOINT, ID 83864-1569
(208) 255-1617
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/22/2016
Last updated
07/07/2016
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