Organization
CORE COUNSELING CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY RYAN MORENO L.C.S.W. (OWNER/PROGRAM MANAGER)
(208) 570-8894
Entity
Organization
Contact information
Practice address
847 PARKCENTRE WAY, SUITE 4, NAMPA, ID 83651-1792
(208) 467-2673
(208) 467-4150
Mailing address
847 PARKCENTRE WAY, SUITE 4, NAMPA, ID 83651-1792
(208) 467-2673
(208) 467-4150
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/04/2012
Last updated
03/05/2013
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