Organization
ALTA ADDICTIONS AND MENTAL HEALTH SERVICES
Active
Organization
ALTA ADDICTIONS AND MENTAL HEALTH SERVICES
Active
Other names
Alta Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LESA MCCONNEL LCSW (CLINICAL DIRECTOR)
(208) 395-1713
Entity
Organization
Contact information
Practice address
5223 W OVERLAND RD, BOISE, ID 83705-2637
(208) 395-1713
(208) 395-1715
Mailing address
5223 W OVERLAND RD, BOISE, ID 83705-2637
(208) 395-1713
(208) 395-1715
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
LCSW 1100
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8064161
—
ID
Enumeration date
05/09/2007
Last updated
06/12/2008
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