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General NPI Number Information
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NPI Number | 1619762960
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Entity Type | Organization
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Legal Business Name | A NEW DIRECTION RECOVERY, LLC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 1524 HELENA DR
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City | CALDWELL
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State | ID
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Zip | 83605-6365
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Country | US
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Telephone | 208-249-2547
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Fax |
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Provider Business Mailing Address
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Address Line | 1524 HELENA DR
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City | CALDWELL
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State | ID
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Zip | 83605-6365
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | JENNY VILLARREAL
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Credential |
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Telephone | 208-249-2547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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