Organization
CANOPY VILLAGE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSA ANJELICA METTLER (EXECUTIVE DIRECTOR)
(208) 667-1189
Entity
Organization
Contact information
Practice address
1350 W HANLEY AVE, COEUR D ALENE, ID 83815-8638
(208) 667-1189
Mailing address
1350 W HANLEY AVE, COEUR D ALENE, ID 83815-8638
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/06/2018
Last updated
01/19/2026
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