LEGACY VILLAGE OUTPATIENT ID, LLC

BOISE, ID
NPI1225721707
Entity TypeOrganization
Authorized ContactDENNIS SCOTT FARMER
Chief Executive Officer
800-997-6977
Organization Subpart ?No
Primary Taxonomy324500000X Substance Abuse Rehabilitation Facility
Additional Taxonomies261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date2023-05-31
Last Update Date2023-05-31
Business Address
LEGACY VILLAGE OUTPATIENT ID, LLC
800 W MAIN ST STE 1460
BOISE, ID 83702-5983
Phone number: 800-997-6977
Mailing Address
LEGACY VILLAGE OUTPATIENT ID, LLC
800 W MAIN ST STE 1460
BOISE, ID 83702-5983
Phone number: 800-997-6977