Organization
LIFE COUNSEING CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY D WRIGHT PH.D., LCPC (CLINICAL DIRECTOR)
(208) 465-5433
Entity
Organization
Contact information
Practice address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 465-5433
Mailing address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 465-5433
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808318000
—
ID
05
—
808445101
—
ID
Enumeration date
09/11/2009
Last updated
09/11/2009
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