| Revitalize Consulting Group, Inc. | |
|
202 S Midland Blvd Nampa ID 83686-2602 | |
| (208) 977-3077 | |
| Not Available |
| Full Name | Revitalize Consulting Group, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 202 S Midland Blvd, Nampa, Idaho |
| Authorized Official Name and Position | Laura L Gayler (PRESIDENT/OWNER) |
| Authorized Official Contact | 2089973077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revitalize Consulting Group, Inc. 202 S Midland Blvd Nampa ID 83686-2602 Ph: (208) 997-3077 | Revitalize Consulting Group, Inc. 202 S Midland Blvd Nampa ID 83686-2602 Ph: (208) 977-3077 |
| NPI Number | 1013535145 |
|---|---|
| Provider Enumeration Date | 07/06/2020 |
| Last Update Date | 07/06/2020 |
| Certification Date | 07/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013535145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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