Organization
LC-ADVANCED HEALTH & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY BRIAN TENNY MSW, CADC (OWNER)
(208) 816-0015
Entity
Organization
Contact information
Practice address
1428 G ST, LEWISTON, ID 83501-2031
(208) 848-4140
(208) 848-4143
Mailing address
1428 G ST, LEWISTON, ID 83501-2031
(208) 848-4140
(208) 848-4143
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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