Provider Demographics
NPI:1760650311
Name:ABIDING SELF INC
Entity Type:Organization
Organization Name:ABIDING SELF INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MERKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-478-2052
Mailing Address - Street 1:427 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-6341
Mailing Address - Country:US
Mailing Address - Phone:208-478-2052
Mailing Address - Fax:208-478-1601
Practice Address - Street 1:427 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-6341
Practice Address - Country:US
Practice Address - Phone:208-478-2052
Practice Address - Fax:208-478-1601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty