Kelley Kids Ranch, LLC

NPI #1134774680 in Lewiston, Idaho

Provider Information

NPI Number: 1134774680
Entity Type: Organization
Organization Name: Kelley Kids Ranch, LLC
Primary Specialty: Counselor - Mental Health
Enumeration Date: Aug 1, 2019
Last Updated: Aug 1, 2019

Practice Location

Address: 602 13TH ST
City: Lewiston
State: Idaho
ZIP Code: 83501-2586
Phone: (208) 675-7350

Authorized Official

Name: AMY T KELLEY
Title: OWNER
Phone: (208) 675-7350

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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