Organization
RESTART COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA HOLLAND (OWNER/PROVIDER)
(208) 930-4383
Entity
Organization
Contact information
Practice address
1625 N 4TH ST STE 102C, COEUR D ALENE, ID 83814-6178
(208) 930-4383
Mailing address
1625 N 4TH ST STE 102C, COEUR D ALENE, ID 83814-6178
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558476150
—
CA
Enumeration date
01/12/2018
Last updated
01/12/2018
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