Healthcare Provider Details

I. General information

NPI: 1578406872
Provider Name (Legal Business Name): RELENTLESS RECOVERY & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 E MAIN ST
JEROME ID
83338-2333
US

IV. Provider business mailing address

152 E MAIN ST
JEROME ID
83338-2333
US

V. Phone/Fax

Practice location:
  • Phone: 208-539-8565
  • Fax:
Mailing address:
  • Phone: 208-539-8565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AMANDA MARIE MCCROREY
Title or Position: OWNER
Credential: SUDA
Phone: 208-595-9113