Provider Demographics
NPI:1912332446
Name:QUALITY CARE COUNSELING CENTER INC.
Entity type:Organization
Organization Name:QUALITY CARE COUNSELING CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SADIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-323-2273
Mailing Address - Street 1:2316 N COLE RD
Mailing Address - Street 2:STE A
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-7365
Mailing Address - Country:US
Mailing Address - Phone:208-323-2273
Mailing Address - Fax:
Practice Address - Street 1:2316 N. COLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704
Practice Address - Country:US
Practice Address - Phone:208-323-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty