Organization
CHANGEPOINT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BEVERLY LYNN FOWLER MA, ACADC (EXECUTIVE DIRECTOR/ OWNER)
(208) 413-2619
Entity
Organization
Contact information
Practice address
1020 MAIN ST, LEWISTON, ID 83501-1842
(208) 750-1000
(208) 750-1009
Mailing address
1020 MAIN ST, LEWISTON, ID 83501-1842
(208) 750-1000
(208) 750-1009
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2013
Last updated
06/23/2016
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