Organization
5 PEPPERS INC.
Active
Other names
DBA Acacia Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEO MARIE PEPPERSACK FNP (OWNER)
(208) 498-1760
Entity
Organization
Contact information
Practice address
217 W GEORGIA AVE STE 120, NAMPA, ID 83686-6812
(208) 498-1760
(208) 498-1769
Mailing address
353 W IOWA AVE, NAMPA, ID 83686-2856
(208) 498-1760
(208) 498-1761
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LMSW-27706
ID
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
656A
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
NP656A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806976700
—
ID
05
—
8083269
—
ID
Enumeration date
02/23/2009
Last updated
03/09/2016
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