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General NPI Number Information
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NPI Number | 1114618774
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Entity Type | Organization
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Legal Business Name | THE FLAME OF HOPE ART THERAPY & COUNSELING
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 136 S ACADEMY AVE
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City | EAGLE
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State | ID
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Zip | 83616-6541
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Country | US
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Telephone | 801-787-4608
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Fax |
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Provider Business Mailing Address
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Address Line | 2512 N STOKESBERRY PL STE 101
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City | MERIDIAN
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State | ID
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Zip | 83646-1135
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Country | US
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Telephone | 986-895-3122
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MRS. ADRIANNA RACHEL BOWYER ANDERSON
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Credential | ATR, LPCC, LCPC
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Telephone | 986-895-3122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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