institution
Idaho Dept Of Health & Welfare Reg 6 Amh Psr Pres
Mental Health Clinic/Center (Including Community Mental Health Center) in Preston, Idaho
NPI 1275664583

Idaho Dept Of Health & Welfare Reg 6 Amh Psr Pres 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 Pres practices in Preston, ID. The NPI Number for Idaho Dept Of Health & Welfare Reg 6 Amh Psr Pres is 1275664583 and holds a License No. (Idaho).

The current practice location address for Idaho Dept Of Health & Welfare Reg 6 Amh Psr Pres is 223 N State St, Preston, ID and can be reached out via phone at 208-852-0634 and via fax at 208-852-2136.

Location: 223 N State St, Preston, ID, 83201-4008
institution
Provider Profile Details
NPI Number
1275664583
Provider Name
Idaho Dept Of Health & Welfare Reg 6 Amh Psr Pres
Credential
Provider Entity Type
Organization
Address
223 N State St, Preston, ID, 83201-4008
Phone Number
208-852-0634
Fax Number
208-852-2136
Provider Enumeration Date
03/08/2007
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
8073684 05 ID
institution
Provider Business Practice Location Address Details
Address
223 N State St
City
State
Zip
83263-1140
Phone Number
208-852-0634
Fax Number
208-852-2136
person
Provider Business Mailing Address Details
Address
223 N State St
City
State
Zip
83263-1140
Phone Number
208-852-0634
Fax Number
208-852-2136
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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