Latah Recovery Community Center, Inc.

NPI #1700512860 in Moscow, Idaho

Provider Information

NPI Number: 1700512860
Entity Type: Organization
Organization Name: Latah Recovery Community Center, Inc.
Primary Specialty: Peer Specialist
Enumeration Date: Jul 29, 2022
Last Updated: Jul 29, 2022

Practice Location

Address: 531 S MAIN
City: Moscow
State: Idaho
ZIP Code: 83843
Phone: (208) 883-1045

Authorized Official

Name: MR. DARRELL ERIC KEIM
Title: EXECUTIVE DIRECTOR
Phone: (208) 883-1045

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Peer Specialist	175T00000X	Primary

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