Organization
GOLDER ENTERPRISES LLC,
Active
Other names
Momentum Mental and Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MARCUS BOYD OLDER LMSW (OWNER)
(208) 201-8881
Entity
Organization
Contact information
Practice address
3867 E 12 N STE 4, RIGBY, ID 83442-4715
(208) 754-0911
(208) 228-0332
Mailing address
3867 E 12 N STE 4, RIGBY, ID 83442-4715
(208) 754-0911
(298) 228-0332
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-32292
ID
251B00000X
Case Management Agency
LMSW-32292
ID
251S00000X
Community/Behavioral Health Agency
LMSW-32292
ID
Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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