Healthcare Provider Details

I. General information

NPI: 1568391522
Provider Name (Legal Business Name): SIENTE WELLNESS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 10/01/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

943 W OVERLAND RD OFC 101
MERIDIAN ID
83642-6541
US

IV. Provider business mailing address

4511 N TEMPEST WAY
MERIDIAN ID
83646-3767
US

V. Phone/Fax

Practice location:
  • Phone: 986-204-8411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALFREDO MEJIA
Title or Position: OWNER
Credential: LCSW
Phone: 208-761-2243