Organization
REDDOOR REHABILITATION INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVITA MARLENE HARRIS B.A. (PRESIDENT)
(208) 354-3005
Entity
Organization
Contact information
Practice address
1420 N HIGHWAY 33 STE 203, DRIGGS, ID 83422-5316
(208) 354-3005
(208) 354-3006
Mailing address
1420 N HIGHWAY 33 STE 203, DRIGGS, ID 83422-5316
(208) 354-3005
(208) 354-3006
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
ID
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806703600
—
ID
05
—
806770100
—
ID
Enumeration date
06/03/2007
Last updated
03/31/2026
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