institution
Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda
Mental Health Clinic/Center (Including Community Mental Health Center) in Coeur D Alene, Idaho
NPI 1023145893

Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Coeur D Alene, ID and is specialized in Mental Health (Including Community Mental Health Center). Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda practices in Coeur D Alene, ID. The NPI Number for Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda is 1023145893 and holds a License No. (Idaho).

The current practice location address for Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda is 2195 Ironwood Ct, Coeur D Alene, ID and can be reached out via phone at 208-769-1406 and via fax at 208-769-1430.

Location: 2195 Ironwood Ct, Coeur D Alene, ID, 83814-2628
institution
Provider Profile Details
NPI Number
1023145893
Provider Name
Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda
Credential
Provider Entity Type
Organization
Address
2195 Ironwood Ct, Coeur D Alene, ID, 83814-2628
Phone Number
208-769-1406
Fax Number
208-769-1430
Provider Enumeration Date
02/27/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0028407 05 ID
000010018348 01 BLUE SHIELD
HW256 01 BLUE CROSS OF IDAHO
institution
Provider Business Practice Location Address Details
Address
2195 Ironwood Ct
City
State
Zip
83814-2628
Phone Number
208-769-1406
Fax Number
208-769-1430
person
Provider Business Mailing Address Details
Address
2195 Ironwood Ct
City
State
Zip
83814-2628
Phone Number
208-769-1406
Fax Number
208-769-1430
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
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Definition
Definition to come...
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