| Ultreia Enlightened Transitions, Llc | |
|
6322 W Robertson Dr Boise ID 83709-2173 | |
| (208) 571-9709 | |
| Not Available |
| Full Name | Ultreia Enlightened Transitions, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6322 W Robertson Dr, Boise, Idaho |
| Authorized Official Name and Position | Heather Mosqueda Crist (OWNER) |
| Authorized Official Contact | 2085719709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ultreia Enlightened Transitions, Llc 6322 W Robertson Dr Boise ID 83709-2173 Ph: (208) 571-9709 | Ultreia Enlightened Transitions, Llc 6322 W Robertson Dr Boise ID 83709-2173 Ph: (208) 571-9709 |
| NPI Number | 1134798341 |
|---|---|
| Provider Enumeration Date | 06/22/2021 |
| Last Update Date | 06/22/2021 |
| Certification Date | 06/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134798341 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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