Organization
LIFE COUNSELING CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATINA JIMINEZ (BILLING SPECIALIST)
(208) 465-5433
Entity
Organization
Contact information
Practice address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 465-5433
(208) 466-5802
Mailing address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 465-5433
(208) 466-5802
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
ID
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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