Provider Demographics
NPI:1629177118
Name:COMMUNITY OUTREACH COUNSELING
Entity Type:Organization
Organization Name:COMMUNITY OUTREACH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:SUZETTE
Authorized Official - Last Name:MARCOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:208-695-1257
Mailing Address - Street 1:1406 N MAIN ST
Mailing Address - Street 2:STE 103
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1795
Mailing Address - Country:US
Mailing Address - Phone:208-888-6123
Mailing Address - Fax:208-888-6482
Practice Address - Street 1:1406 N MAIN ST
Practice Address - Street 2:STE 103
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1795
Practice Address - Country:US
Practice Address - Phone:208-888-6123
Practice Address - Fax:208-888-6482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based