Healthcare Provider Details

I. General information

NPI: 1285767574
Provider Name (Legal Business Name): ALL HORIZONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6933 W EMERALD ST
BOISE ID
83704-8616
US

IV. Provider business mailing address

6933 W EMERALD ST
BOISE ID
83704-8616
US

V. Phone/Fax

Practice location:
  • Phone: 208-321-0634
  • Fax: 208-321-1082
Mailing address:
  • Phone: 208-321-0634
  • Fax: 208-321-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. KELLIE HUMPHERYS
Title or Position: EXECUTIVE DIRECTOR
Credential: LMSW
Phone: 208-321-0634