| Kelly Companies, Llc | |
|
13019 Ponderosa Dr Donnelly ID 83615 | |
| (208) 880-8727 | |
| Not Available |
| Full Name | Kelly Companies, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 13019 Ponderosa Dr, Donnelly, Idaho |
| Authorized Official Name and Position | Jamie Tisa Coffey-kelly (PRESIDENT/CEO) |
| Authorized Official Contact | 2088808727 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Companies, Llc Po Box 416 Donnelly ID 83615-0416 Ph: (208) 880-8727 | Kelly Companies, Llc 13019 Ponderosa Dr Donnelly ID 83615 Ph: (208) 880-8727 |
| NPI Number | 1487310074 |
|---|---|
| Provider Enumeration Date | 11/09/2021 |
| Last Update Date | 11/09/2021 |
| Certification Date | 11/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487310074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |