Organization
STELLAR MENTAL HEALTH & MEDIATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY RYAN MORENO LSCW (OWNER/PROGRAM MANAGER)
(208) 639-1514
Entity
Organization
Contact information
Practice address
923 16TH AVE S, NAMPA, ID 83651-4731
(208) 639-1514
(208) 639-2301
Mailing address
923 16TH AVE S, NAMPA, ID 83651-4731
(208) 639-1514
(208) 639-2301
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/14/2014
Last updated
07/20/2023
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