Organization
PEAK RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHONNE LEE PIEKMSA MS, , LPC ACADC (OWNER)
(208) 455-1788
Entity
Organization
Contact information
Practice address
2423 S GEORGIA AVE, CALDWELL, ID 83605-4477
(208) 455-1788
(208) 455-2044
Mailing address
2423 S GEORGIA AVE, CALDWELL, ID 83605-4477
(208) 455-1788
(208) 455-2044
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
151
ID
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
LPC-5173
ID
Other
Enumeration date
07/15/2013
Last updated
04/14/2021
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