Organization
WHITETAIL TREATMENT AND COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY PEREZ LCSW, ACADC (OWNER)
(208) 859-9110
Entity
Organization
Contact information
Practice address
925 N MAIN ST STE D, MERIDIAN, ID 83642-2301
(208) 907-5322
Mailing address
925 N MAIN ST STE D, MERIDIAN, ID 83642-2301
(208) 907-5322
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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