Organization
MAITRI COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JESSICA LEE GORRINGE BA, MS, LPC, NCC (LICENSED PRACTICING COUNSELOR)
(208) 284-8450
Entity
Organization
Contact information
Practice address
3709 N LOCUST GROVE RD, SUITE 100, MERIDIAN, ID 83646-6449
(208) 284-8450
Mailing address
3709 N LOCUST GROVE RD, MERIDIAN, ID 83646-6449
(208) 284-8450
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC-5927
ID
Other
Enumeration date
07/14/2015
Last updated
07/28/2015
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