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Organization

LATAH RECOVERY COMMUNITY CENTER, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DARRELL ERIC KEIM (EXECUTIVE DIRECTOR)
(208) 883-1045
Entity
Organization

Contact information

Practice address
531 S MAIN, MOSCOW, ID 83843
(208) 883-1045
Mailing address
531 S MAIN, MOSCOW, ID 83843
(208) 883-1045

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
175T00000X
Peer Specialist
Primary

Other

Enumeration date
07/29/2022
Last updated
07/29/2022
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