Organization
CROSSROADS HEALTH IDAHO LLC
Active
Parent organization
CROSSROADS OF WESTERN IOWA
Organization subpart
Yes
Provider details
NPI number
Legal business name
CROSSROADS OF WESTERN IOWA
Authorized official
DARIAN ZIMA (CFO)
(712) 256-7888
Entity
Organization
Contact information
Practice address
8950 W EMERALD ST STE 178, BOISE, ID 83704-8296
(208) 376-7083
Mailing address
1851 MADISON AVE STE 718, COUNCIL BLUFFS, IA 51503-3602
(712) 256-7888
(712) 256-6502
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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