Organization
SNAKE RIVER COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULI POPEJOY (BILLING MANAGER)
(208) 525-2090
Entity
Organization
Contact information
Practice address
2635 CHANNING WAY, SUITE B, IDAHO FALLS, ID 83404-7518
(208) 552-0490
(208) 552-2518
Mailing address
2635 CHANNING WAY, SUITE B, IDAHO FALLS, ID 83404-7518
(208) 552-0490
(208) 552-2518
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
02/24/2015
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