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Organization

STILL WATERS REFUGE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHELBY WHITING LPC (OWNER)
(208) 569-8599
Entity
Organization

Contact information

Practice address
1329 AMMON PARK DR, AMMON, ID 83406-4591
(208) 569-8599
Mailing address
1329 AMMON PARK DR, AMMON, ID 83406-4591
(208) 569-8599

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
12/18/2024
Last updated
12/18/2024
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