Organization
MENTAL HEALTH JIU JITSU PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANTE SANDRO RUMORE LICSW (OWNER/PROVIDER)
(208) 627-9930
Entity
Organization
Contact information
Practice address
105 PINE ST STE 105A, SANDPOINT, ID 83864-1369
(208) 627-9930
Mailing address
105 PINE ST STE 105A, SANDPOINT, ID 83864-1369
(208) 627-9930
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
11/14/2024
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