Organization
FREE FALLIN LLC
Active
Other names
Ellie Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
RANDI MCDERMOTT (OWNER)
(208) 761-0533
Entity
Organization
Contact information
Practice address
3676 N HARBOR LN, BOISE, ID 83703-6918
(208) 761-0533
Mailing address
2939 N LANCASTER DR, BOISE, ID 83702-0644
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/02/2022
Last updated
05/10/2022
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