Provider Demographics
NPI:1861245201
Name:SALMON RIVER SERENITY WELLNESS PLLC
Entity type:Organization
Organization Name:SALMON RIVER SERENITY WELLNESS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, ACADC
Authorized Official - Phone:208-413-1087
Mailing Address - Street 1:PO BOX 4222
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83711-4222
Mailing Address - Country:US
Mailing Address - Phone:208-413-1087
Mailing Address - Fax:
Practice Address - Street 1:9492 W FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8101
Practice Address - Country:US
Practice Address - Phone:208-413-1087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty