Organization
DRAGONFLY SUPPORT SERVICES, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAILEY J WHITE LCSW (MEMBER)
(208) 691-1251
Entity
Organization
Contact information
Practice address
1105 W IRONWOOD DR LOWR LEVEL, COEUR D ALENE, ID 83814-2613
(208) 676-1075
Mailing address
PO BOX 207, POST FALLS, ID 83877-0207
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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