Organization
TEEN HOPE OF IDAHO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA CROSS (PRESIDENT)
(208) 794-3586
Entity
Organization
Contact information
Practice address
10020 W FAIRVIEW AVE STE 204, BOISE, ID 83704-8571
(208) 991-4649
Mailing address
10020 W FAIRVIEW AVE STE 204, BOISE, ID 83704-8571
(208) 991-4649
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
ID
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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