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General NPI Number Information
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NPI Number | 1609328582
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Entity Type | Organization
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Legal Business Name | ALPHA COUNSELING
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 10/26/2016
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Provider Practice Location Address
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Address Line | 1410 LINCOLN WAY
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2300
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Country | US
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Telephone | 407-780-9487
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Fax |
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Provider Business Mailing Address
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Address Line | 1410 LINCOLN WAY
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2300
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Country | US
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Telephone | 407-780-9487
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Fax |
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Authorized Official
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Title or Position | CADC
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Name | DEBBIE JANETH NUNEZ
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Credential | PHD
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Telephone | 407-780-9487
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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 | CADC10194
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License Number State | ID
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