Fulfillment LLC

NPI #1679287296 in Caldwell, Idaho

Provider Information

NPI Number: 1679287296
Entity Type: Organization
Organization Name: Fulfillment LLC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Jan 9, 2023
Last Updated: Jan 9, 2023

Practice Location

Address: 14331 CREGO ST
City: Caldwell
State: Idaho
ZIP Code: 83607-4815
Phone: (208) 284-7233

Authorized Official

Name: KENDRA JEAN NIELSON, LPC
Title: MANAGER
Phone: (208) 284-7233

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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