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General NPI Number Information
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NPI Number | 1962707166
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Entity Type | Organization
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Legal Business Name | RAISE THE BOTTOM TRAINING & COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 9196 W BARNES DR
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City | BOISE
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State | ID
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Zip | 83709-1552
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Country | US
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Telephone | 208-433-0400
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Fax | 208-433-5271
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Provider Business Mailing Address
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Address Line | 9196 W BARNES DR
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City | BOISE
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State | ID
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Zip | 83709-1552
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Country | US
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Telephone | 208-433-0400
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Fax | 208-433-5271
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Authorized Official
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Title or Position | BILLER
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Name | MS. COURTNEY FERRARESE
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Credential |
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Telephone | 208-433-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LMSW29959
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MSW07060
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | N21523
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | N40356
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License Number State | ID
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | CS5613
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License Number State | ID
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Taxonomy #6
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | M6153
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License Number State | ID
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Taxonomy #7
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CS5613
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License Number State | ID
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