Organization
LIVING HOPE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES M RICE PH.D (OWNER)
(208) 378-1122
Entity
Organization
Contact information
Practice address
3308 N COLE RD, SUITE A, BOISE, ID 83704-4403
(208) 378-1122
Mailing address
3308 N COLE RD, SUITE A, BOISE, ID 83704-4403
(208) 378-1122
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N9212
BLUE CROSS
ID
Enumeration date
12/26/2006
Last updated
08/13/2007
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