A New Leaf, INC

NPI #1629492814 in Meridian, Idaho

Provider Information

NPI Number: 1629492814
Entity Type: Organization
Organization Name: A New Leaf, INC
Subpart: Yes (part of a larger organization)
Parent Organization: A NEW LEAF
Primary Specialty: Family Medicine
Enumeration Date: Feb 10, 2014
Last Updated: Feb 10, 2014

Practice Location

Address: 2548 N STOKESBERRY PL
City: Meridian
State: Idaho
ZIP Code: 83646-1144
Phone: (208) 695-6355

Authorized Official

Name: DR. BRIAN KEITH CROWNOVER, M.D.
Title: VICE PRESIDENT
Phone: (208) 695-6355

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X
Family Medicine	207Q00000X	Primary

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