Organization
JX2 LLC
Active
Other names
Trivium Life Services
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI WILLIAMS (BILLING/CREDENTIALING)
(208) 376-7083
Entity
Organization
Contact information
Practice address
8950 W EMERALD ST STE 178, BOISE, ID 83704-8296
(208) 376-7083
(208) 321-5069
Mailing address
8950 W EMERALD ST STE 178, BOISE, ID 83704-8296
(208) 376-7083
(208) 321-5069
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/10/2022
Last updated
03/31/2022
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