Organization
POWDER BASIN ASSOCAITES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN MOORE (OWNER PRESIDENT)
(208) 209-0535
Entity
Organization
Contact information
Practice address
7905 N MEADOWLARK WAY, SUITE C, COEUR D ALENE, ID 83815-5041
(208) 762-3979
Mailing address
7905 N MEADOWLARK WAY, SUITE C, COEUR D ALENE, ID 83815-5041
(208) 762-3979
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/30/2007
Last updated
08/22/2020
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