Organization
RIVERSIDE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHTON W HOLBROOK LCSW (OWNER)
(208) 417-9638
Entity
Organization
Contact information
Practice address
167 N 710 W, BLACKFOOT, ID 83221-5380
(208) 417-9638
Mailing address
167 N 710 W, BLACKFOOT, ID 83221-5380
(208) 417-9638
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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