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General NPI Number Information
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NPI Number | 1609511856
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Entity Type | Organization
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Legal Business Name | DEMREN LAHHF, LLC
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 1820 SOUTH EAGLE RD
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City | MERIDIAN
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State | ID
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Zip | 83642-2447
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Country | US
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Telephone | 651-583-4447
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Fax |
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Provider Business Mailing Address
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Address Line | 1905 E TRAIL BLAZER DR
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City | MERIDIAN
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State | ID
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Zip | 83646-5864
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Country | US
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Telephone | 651-583-4447
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEMETRIA RAMAKERS
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Credential |
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Telephone | 208-863-6423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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