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LOST RIVER WELLNESS NPI 1497235469


NPI Information

NPI: 1497235469
Provider Name: LOST RIVER WELLNESS

Doing Business As: LOST RIVER WELLNESS

Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
3080 E GENTRY WAY STE 100
MERIDIAN, ID
ZIP 83642
Phone: (208) 810-2318
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LOST RIVER WELLNESS is an adult mental health clinic center in Meridian, ID. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. LOST RIVER WELLNESS NPI is 1497235469. The provider is registered as an organization entity type.
The provider Is Doing Business As Lost River Wellness.

The provider's business location address is:

3080 E GENTRY WAY STE 100
MERIDIAN, ID
ZIP 83642-060
Phone: (208) 810-2318

The provider's authorized official is Jeff Brown .
The authorized official title is Chief Business Officer and has the following contact phone number (208) 484-1447.

The enumeration date for this NPI number is 8/18/2018 and was last updated on 11/28/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM0850XClinic/CenterAdult Mental HealthM11538IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.