Provider Demographics
NPI:1407203623
Name:HUMAN CONNECTION INC
Entity Type:Organization
Organization Name:HUMAN CONNECTION INC
Other - Org Name:SANDPOINT NEUROTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:RIDGWAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:208-265-5412
Mailing Address - Street 1:2023 SANDPOINT WEST DR
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-7304
Mailing Address - Country:US
Mailing Address - Phone:208-265-5412
Mailing Address - Fax:
Practice Address - Street 1:2023 SANDPOINT WEST DR
Practice Address - Street 2:
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864-7304
Practice Address - Country:US
Practice Address - Phone:208-265-5412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC 135101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty