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Organization

COMMONPLACE WELLNESS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ISSA NTAKARUTIMANA LCSW (OWNER / CLINICIAN)
(208) 906-5878
Entity
Organization

Contact information

Practice address
500 W BANNOCK ST, BOISE, ID 83702-5916
(208) 906-5878
Mailing address
205 S BRUCE LN, BOISE, ID 83712-7804

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1041C0700X
Clinical Social Worker

Other

Enumeration date
07/25/2024
Last updated
05/18/2025
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