National Provider Identifier Database

IRON ROOTS RECOVERY MENTAL WELLNESS LLC
Mental Health (Including Community Mental Health Center)

Contact Information

IRON ROOTS RECOVERY & MENTAL WELLNESS, LLC
2025 W PARK PL STE 105
COEUR D'ALENE, ID  83814-2787
Phone: 208-659-2049
Fax: 208-719-7952
Website:
Specialty Taxonomy Code
* Mental Health (Including Community Mental Health Center) 261QM0801X
Adolescent and Children Mental Health 261QM0855X
Adult Mental Health 261QM0850X
Mental Health 101YM0800X
Rehabilitation, Substance Use Disorder 261QR0405X

* Indicates primary specialty

NPI Profile & details for IRON ROOTS RECOVERY & MENTAL WELLNESS, LLC

NPI Number 1104626944
Legal business name
LBN		 IRON ROOTS RECOVERY & MENTAL WELLNESS, LLC
Authorized official JENNIFER MAYBERRY - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 03/18/2025
Last updated 05/13/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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