| Galactic Tribe Llc | |
|
8100 W Emerald St Ste 150 Boise ID 83704-9057 | |
| (208) 908-6399 | |
| (866) 275-9883 |
| Full Name | Galactic Tribe Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8100 W Emerald St Ste 150, Boise, Idaho |
| Authorized Official Name and Position | Jessica Trent (OWNER) |
| Authorized Official Contact | 2089086399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Galactic Tribe Llc 8100 W Emerald St Ste 150 Boise ID 83704-9057 Ph: (208) 908-6399 | Galactic Tribe Llc 8100 W Emerald St Ste 150 Boise ID 83704-9057 Ph: (208) 908-6399 |
| NPI Number | 1093446627 |
|---|---|
| Provider Enumeration Date | 06/23/2022 |
| Last Update Date | 06/23/2022 |
| Certification Date | 06/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093446627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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