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General NPI Number Information
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NPI Number | 1932821899
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Entity Type | Organization
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Legal Business Name | LIFE MATTERS; IF NOT NOW, WHEN LLC
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 248 OLD POLLOCK RD
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City | POLLOCK
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State | ID
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Zip | 83547
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Country | US
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Telephone | 208-315-0993
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 192
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City | POLLOCK
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State | ID
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Zip | 83547-0192
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Country | US
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Telephone | 208-315-0993
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HEIDY MEAD
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Credential | LPC, M ED
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Telephone | 208-315-0993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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