| NPI | 1326877762 |
|---|---|
| Other Name | ADDI, LLC |
| Doing Business As | ADD CLINIC OF IDAHO |
| Entity Type | Organization |
| Authorized Contact | KYLE RONNAU CEO/Medical Director 208-515-2273 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-08-01 |
| Last Update Date | 2024-10-14 |