Organization
ROOTED RECOVERY AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE LYNN FRASER MS, LPC (EXECUTIVE DIRECTOR)
(888) 455-1642
Entity
Organization
Contact information
Practice address
5418 N EAGLE RD STE 160, BOISE, ID 83713-0100
(541) 844-3577
Mailing address
85835 ALLBRITAIN LN, EUGENE, OR 97405-8403
(541) 972-1891
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106S00000X
Behavior Technician
—
—
133V00000X
Registered Dietitian
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
10/26/2022
Last updated
04/03/2024
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