Lake City Counseling Center

NPI #1356981419 in Hayden, Idaho

Provider Information

NPI Number: 1356981419
Entity Type: Organization
Organization Name: Lake City Counseling Center
Subpart: Yes (part of a larger organization)
Parent Organization: PEER SUPPORT
Primary Specialty: Peer Specialist
Enumeration Date: Jan 7, 2020
Last Updated: Jan 7, 2020

Practice Location

Address: 9705 N SHAW ST
City: Hayden
State: Idaho
ZIP Code: 83835-9716
Phone: (208) 625-9981

Authorized Official

Name: JENNIFER RIAN TUTTLE
Title: OWNER
Phone: (208) 819-2716

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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