| NPI | 1669612271 |
|---|---|
| Doing Business As | DBA ACACIA WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | DEO MARIE PEPPERSACK Owner 208-498-1760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID NP656A) |
| 1041C0700X Social Worker, Clinical (Licence: ID LMSW-27706) | |
| 363LF0000X Nurse Practitioner, Family (Licence: ID 656A) | |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2016-03-09 |