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1982428306
INTENTIONAL SUPPORT, LLC
BOISE, ID
NPI
1982428306
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Entity Type
Organization
Authorized Contact
KATIE J GULLICKSON
Registered Agent
208-371-0641
Organization Subpart ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2024-11-12
Last Update Date
2024-11-12
Business Address
INTENTIONAL SUPPORT, LLC
5840 S MANDOLIN PL
BOISE, ID 83709-6377
Phone number: 208-371-0641
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Mailing Address
INTENTIONAL SUPPORT, LLC
5840 S MANDOLIN PL
BOISE, ID 83709-6377
Phone number: 208-371-0641
Copy
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