Organization
CANDLEWOOD FAMILY COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLA C DINGMAN LCSW, ACSW (PRESIDENT, MANAGER)
(208) 478-8340
Entity
Organization
Contact information
Practice address
335 N MAIN ST, POCATELLO, ID 83204-3108
(208) 478-8340
(208) 478-8341
Mailing address
335 N MAIN ST, PO BOX 2306, POCATELLO, ID 83204-3108
(208) 478-8340
(208) 478-8341
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8059487
—
ID
Enumeration date
06/27/2007
Last updated
08/22/2020
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