Organization
HIGHER GROUND RETREAT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BEATRICE SUSAN CARROLL LCSW, LMFT (EXECUTIVE DIRECTOR)
(208) 440-7009
Entity
Organization
Contact information
Practice address
17626 DEER FLAT RD, CALDWELL, ID 83607-9779
(855) 497-4763
Mailing address
17626 DEER FLAT RD, CALDWELL, ID 83607-9779
(855) 497-4763
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
LCSW 1159
ID
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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