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General NPI Number Information
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NPI Number | 1811871940
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Entity Type | Organization
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Legal Business Name | MINDFUL RECOVERY SERVICES PLLC
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 2201 N GOVERNMENT WAY STE K
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City | COEUR D ALENE
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State | ID
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Zip | 83814-3658
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Country | US
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Telephone | 208-819-6122
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Fax | 866-606-2375
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Provider Business Mailing Address
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Address Line | 2201 N GOVERNMENT WAY STE K
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City | COEUR D ALENE
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State | ID
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Zip | 83814-3658
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Country | US
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Telephone | 208-819-6122
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Fax | 866-606-2375
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH CHRISTINA CARDER
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Credential | LCSW
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Telephone | 208-819-6122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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Taxonomy #4
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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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