Living Waters Coordinated Communities, Inc.

NPI 1215153432 - Clinic/Center - 261QP3300X

NPI Details
NPI 1215153432
Enumeration Date 04/17/2007
Last Updated 09/28/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LAVERL H LAVERL
Position PRESIDENT, PSYCHOLOGIST
Phone (208) 676-0926
Fax (208) 676-0926
Practice Location
2108 N IRONWOOD CENTER DR
COEUR D ALENE ID, 83814, US
Phone (208) 676-0926
Fax (208) 676-0926
Business Location
212 W IRONWOOD DR
SUITE D311
COEUR D ALENE ID, 83814-1403, US
Phone (208) 676-0926
Fax (208) 676-0926
Toxanomy
Taxonomy Code 261QP3300X
License State Idaho
License Number PSYCHOLOGY 202060
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According to our database, Living Waters Coordinated Communities, Inc. NPI is 1215153432, taxonomy code is 261QP3300X and license number is PSYCHOLOGY 202060, license state is located at Idaho. Living Waters Coordinated Communities, Inc. physically located at 2108 N Ironwood Center Dr, Coeur D Alene ID, 83814. NPI Number 1033115704 has the healthcare provider type.

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1215153432 NPI number is provided on an as is basis without warranty of any kind. 1215153432 is maintained by the National Plan & Provider Enumeration System. The contents of Living Waters Coordinated Communities, Inc. are for informational purposes only.