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General NPI Number Information
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NPI Number | 1255548756
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Entity Type | Organization
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Legal Business Name | BETTER OPTIONS LLC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 04/04/2008
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Provider Practice Location Address
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Address Line | 1023 YELLOWSTONE AVE SUITE K
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City | POCATELLO
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State | ID
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Zip | 83201-4478
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Country | US
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Telephone | 208-478-9551
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Fax | 208-478-1507
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Provider Business Mailing Address
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Address Line | PO BOX 2921
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City | POCATELLO
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State | ID
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Zip | 83206-2921
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Country | US
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Telephone | 208-478-9551
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Fax | 208-478-1507
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Authorized Official
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Title or Position | CLINICAL PROFESSIONAL COUNSELOR
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Name | MR. JOHN P CONDRON
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Credential | M.S.
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Telephone | 208-478-9551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCPC-3868
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License Number State | ID
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