OrganizationActive
Restoration Wellness of Idaho LLC
NPI 1386476380 · Pastoral Counselor · Boise, ID
Provider details
- NPI number
- 1386476380
- Entity type
- Organization
- Primary specialty
- Pastoral CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Melanie Long-Azary, Owner(208) 794-4737
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
- Case Manager/Care Coordinator171M00000X
Other Service Providers
- Interpreter171R00000X
Other Service Providers
- Peer Specialist175T00000X
Other Service Providers
Practice location
3164 E Eastgate Dr
Boise, ID 83716-5637
Phone: (208) 794-4737
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 171362
Boise, ID 83717-1362
Registry dates
- Enumerated
- 2024-08-17
- Last updated
- 2024-08-17
- Certified
- 2024-08-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.