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Individual

JESUS ORTEGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CADC

Contact information

Practice address
762 FALLS AVE, TWIN FALLS, ID 83301-3316
(208) 734-4200
(208) 734-1404
Mailing address
605 11TH AVE E, GOODING, ID 83330-5368
(208) 934-8461
(208) 934-5437

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1146006
ID

Other

Enumeration date
04/22/2008
Last updated
04/22/2008
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