Organization
EDUCELL
Active
Other names
Mountain Family Therapy, Mountain Family Therapy Rural
Organization subpart
No
Provider details
NPI number
Authorized official
CADE DOPP (OWNER)
(801) 755-7327
Entity
Organization
Contact information
Practice address
265 SPRING LN, CLARK FORK, ID 83811-5502
(801) 755-7327
Mailing address
265 SPRING LN, CLARK FORK, ID 83811-5502
(801) 755-7327
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
04/25/2025
Last updated
05/21/2025
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