Organization
THE GENSHAI TRAUMA RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY QUIROZ (OWNER)
(208) 406-6194
Entity
Organization
Contact information
Practice address
1820 E 17TH ST STE 190, IDAHO FALLS, ID 83404-6518
(208) 244-4384
(208) 549-9618
Mailing address
1820 E 17TH ST STE 190, IDAHO FALLS, ID 83404-6518
(208) 244-4384
(208) 549-9618
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/28/2018
Last updated
12/28/2018
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