| Jaci Moore, Llc | |
|
690 S Industry Way Ste 45 Meridian ID 83642-7907 | |
| (801) 808-4129 | |
| Not Available |
| Full Name | Jaci Moore, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 690 S Industry Way Ste 45, Meridian, Idaho |
| Authorized Official Name and Position | Jacqueline Moore (OWNER) |
| Authorized Official Contact | 8018084129 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaci Moore, Llc 690 S Industry Way Ste 45 Meridian ID 83642-7907 Ph: (801) 808-4129 | Jaci Moore, Llc 690 S Industry Way Ste 45 Meridian ID 83642-7907 Ph: (801) 808-4129 |
| NPI Number | 1528926185 |
|---|---|
| Provider Enumeration Date | 01/13/2026 |
| Last Update Date | 01/13/2026 |
| Certification Date | 01/13/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528926185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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