Organization
JX2 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY EVANS (BILLING SUPERVISOR)
(208) 323-9130
Entity
Organization
Contact information
Practice address
1253 N COLE RD, SUITE 100, BOISE, ID 83704-8647
(208) 319-0700
(208) 321-5069
Mailing address
PO BOX 16820, BOISE, ID 83715-6820
(208) 323-9130
(208) 323-9070
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
12/06/2010
Last updated
12/06/2010
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