Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Living Water Youth Ranch

Organization Addiction (Substance Use Disorder) Counselor · NPI 1528795093

Living Water Youth Ranch is an Addiction (Substance Use Disorder) Counselor in Hayden, Idaho. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2

Practice location Address checks out

8382 N Wayne Dr Ste 201
Hayden, ID 83835-6028
Phone: (208) 762-8777
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1528795093
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marissa McCreary — Office Manager · (208) 981-1992
NPI enumeratedAugust 4, 2022
Last updated in NPPESAugust 4, 2022
Certification dateAugust 4, 2022
Mailing address8382 N Wayne Dr Ste 201, Hayden, ID 83835-6028

Other providers in Hayden