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General NPI Number Information
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NPI Number | 1831914712
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Entity Type | Organization
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Legal Business Name | LAVOI LANDING
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 2484 N STOKESBERRY PL
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City | MERIDIAN
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State | ID
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Zip | 83646-6085
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Country | US
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Telephone | 775-315-5020
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Fax |
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Provider Business Mailing Address
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Address Line | 4458 E FACETO ST
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City | MERIDIAN
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State | ID
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Zip | 83642-5720
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Country | US
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Telephone | 775-315-5020
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALISA LAVOI
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Credential | LCSW
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Telephone | 773-315-5020
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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 |
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License Number State |
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