Provider Demographics
NPI:1609631084
Name:RURAL EDUCATIONAL SERVICES LLC
Entity Type:Organization
Organization Name:RURAL EDUCATIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:208-297-8227
Mailing Address - Street 1:4090 W STATE ST STE 106
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703-4450
Mailing Address - Country:US
Mailing Address - Phone:208-297-8227
Mailing Address - Fax:
Practice Address - Street 1:4090 W STATE ST STE 106
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703-4450
Practice Address - Country:US
Practice Address - Phone:208-297-8227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health