Organization
LIFESTYLE CHANGES COUNSELING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM L VIRTUE (PRESIDENT)
(208) 316-5436
Entity
Organization
Contact information
Practice address
219 GOODING ST N, TWIN FALLS, ID 83301-6178
(208) 734-5230
(208) 732-5894
Mailing address
219 GOODING ST N, TWIN FALLS, ID 83301-6178
(208) 734-5230
(208) 732-5894
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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