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General NPI Number Information
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NPI Number | 1437376357
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Entity Type | Organization
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Legal Business Name | INNER VISIONS LLC
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1214 12TH AVE SOUTH
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City | NAMPA
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State | ID
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Zip | 83651
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Country | US
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Telephone | 208-880-4299
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Fax | 208-465-0729
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Provider Business Mailing Address
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Address Line | 1214 12TH AVE SOUTH
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City | NAMPA
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State | ID
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Zip | 83651
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Country | US
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Telephone | 208-880-4299
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Fax | 208-465-0729
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Authorized Official
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Title or Position | PARTNER
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Name | MRS. ANITA LYNN ANDERSON
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Credential | LPC
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Telephone | 208-880-4299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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