Organization
TUELLER COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM TUELLER MLSW (OWNER)
(208) 524-7400
Entity
Organization
Contact information
Practice address
2275 W BROADWAY ST, SUITE G, IDAHO FALLS, ID 83402-2902
(208) 524-7400
Mailing address
2275 W BROADWAY ST, SUITE G, IDAHO FALLS, ID 83402-2902
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
CADC 10090
ID
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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