PHIL WAGGONER

LEWISTON, ID
NPI1871651422
Doing Business AsRIVERSIDE RECOVERY
Entity TypeOrganization
Authorized ContactDANA K BOYD
Business Ofc Manager Owner
208-746-4097
Organization Subpart ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID  138)
Enumeration Date2006-12-05
Last Update Date2020-08-22
Business Address
PHIL WAGGONER
1720 18TH AVE
LEWISTON, ID 83501-4047
Phone number: 208-746-4097
Mailing Address
PHIL WAGGONER
1720 18TH AVE
LEWISTON, ID 83501
Phone number: 208-746-4097