institution
Idaho Dept Of Health & Welfare Amh Psr Mt Home
Mental Health Clinic/Center (Including Community Mental Health Center) in Mountain Home, Idaho
NPI 1720118904

Idaho Dept Of Health & Welfare Amh Psr Mt Home is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Boise, ID and is specialized in Mental Health (Including Community Mental Health Center). Idaho Dept Of Health & Welfare Amh Psr Mt Home practices in Mountain Home, ID. The NPI Number for Idaho Dept Of Health & Welfare Amh Psr Mt Home is 1720118904 and holds a License No. (Idaho).

The current practice location address for Idaho Dept Of Health & Welfare Amh Psr Mt Home is 2420 American Legion Blvd, Mountain Home, ID and can be reached out via phone at 208-587-9061 and via fax at 208-587-5024. You can also correspond with Idaho Dept Of Health & Welfare Amh Psr Mt Home through the mailing address at 1720 WESTGATE DR, BOISE, ID - 83704-7164 (mailing address contact number: 208-334-0894).

Location: 2420 American Legion Blvd, Mountain Home, ID, 83704-7164
institution
Provider Profile Details
NPI Number
1720118904
Provider Name
Idaho Dept Of Health & Welfare Amh Psr Mt Home
Credential
Provider Entity Type
Organization
Address
2420 American Legion Blvd, Mountain Home, ID, 83704-7164
Phone Number
208-587-9061
Fax Number
208-587-5024
Provider Enumeration Date
03/06/2007
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
8073418 05 ID
000010018973 01 BLUE SHIELD
HW280 01 BLUE CROSS OF IDAHO
institution
Provider Business Practice Location Address Details
Address
2420 American Legion Blvd
City
State
Zip
83647-3146
Phone Number
208-587-9061
Fax Number
208-587-5024
person
Provider Business Mailing Address Details
Address
2420 American Legion Blvd
City
State
Zip
83647-3146
Phone Number
208-587-9061
Fax Number
208-587-5024
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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