Organization
LIFE CHANGES MENTAL HEALTH SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH L VON BARGEN NP (NURSE PRACTITIONER, OWNER)
(208) 791-6183
Entity
Organization
Contact information
Practice address
816 MAIN STREET, LEWISTON, ID 83501-1870
(208) 791-6183
(949) 404-8139
Mailing address
PO BOX 472, CRAIGMONT, ID 83523-0472
(208) 791-6183
(949) 404-8139
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/05/2019
Last updated
04/07/2023
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