institution
Idaho Dept Of Health & Welfare Reg 6 Amh Psr Poc
Mental Health Clinic/Center (Including Community Mental Health Center) in Pocatello, Idaho
NPI 1225169139

Idaho Dept Of Health & Welfare Reg 6 Amh Psr Poc is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Pocatello, ID and is specialized in Mental Health (Including Community Mental Health Center). Idaho Dept Of Health & Welfare Reg 6 Amh Psr Poc practices in Pocatello, ID. The NPI Number for Idaho Dept Of Health & Welfare Reg 6 Amh Psr Poc is 1225169139 and holds a License No. (Idaho).

The current practice location address for Idaho Dept Of Health & Welfare Reg 6 Amh Psr Poc is 421 Memorial Dr, Pocatello, ID and can be reached out via phone at 208-234-7900 and via fax at 208-236-6328.

Location: 421 Memorial Dr, Pocatello, ID, 83201-4008
institution
Provider Profile Details
NPI Number
1225169139
Provider Name
Idaho Dept Of Health & Welfare Reg 6 Amh Psr Poc
Credential
Provider Entity Type
Organization
Address
421 Memorial Dr, Pocatello, ID, 83201-4008
Phone Number
208-234-7900
Fax Number
208-236-6328
Provider Enumeration Date
03/09/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
HW108 01 ID BLUE CROSS OF IDAHO
000010019235 01 ID BLUE SHIELD
0028411 05 ID
institution
Provider Business Practice Location Address Details
Address
421 Memorial Dr
City
State
Zip
83201-4008
Phone Number
208-234-7900
Fax Number
208-236-6328
person
Provider Business Mailing Address Details
Address
421 Memorial Dr
City
State
Zip
83201-4008
Phone Number
208-234-7900
Fax Number
208-236-6328
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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