Organization
FAMILY LIFE COUNSELING CENTER LLC
Active
Other names
Family Life Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE MICHAEL DUTY LCPC (PRESIDENT)
(208) 407-8014
Entity
Organization
Contact information
Practice address
1159 E IRON EAGLE DR STE 170, EAGLE, ID 83616-6870
(208) 407-8014
Mailing address
1159 E IRON EAGLE DR STE 170, EAGLE, ID 83616-6870
(208) 407-8014
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/05/2023
Last updated
01/16/2024
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