Organization
AVANZAR WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE CARBAJAL MS (DIRECTOR OF OPERATIONS)
(208) 908-7882
Entity
Organization
Contact information
Practice address
10096 W FAIRVIEW AVE STE 160, BOISE, ID 83704-5004
(208) 908-7882
(208) 908-7883
Mailing address
10096 W FAIRVIEW AVE STE 160, BOISE, ID 83704-5004
(208) 908-7882
(208) 908-7883
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
06/02/2025
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