institution
Idaho Dept Of Health & Welfare Reg 1 Amh Psr Kellogg
Mental Health Clinic/Center (Including Community Mental Health Center) in Kellogg, Idaho
NPI 1730216961

Idaho Dept Of Health & Welfare Reg 1 Amh Psr Kellogg is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Kellogg, ID and is specialized in Mental Health (Including Community Mental Health Center). Idaho Dept Of Health & Welfare Reg 1 Amh Psr Kellogg practices in Kellogg, ID. The NPI Number for Idaho Dept Of Health & Welfare Reg 1 Amh Psr Kellogg is 1730216961 and holds a License No. (Idaho).

The current practice location address for Idaho Dept Of Health & Welfare Reg 1 Amh Psr Kellogg is 35 Wildcat Way Ste B, Kellogg, ID and can be reached out via phone at 208-784-1351 and via fax at 208-784-1356.

Location: 35 Wildcat Way Ste B, Kellogg, ID, 83837-2261
institution
Provider Profile Details
NPI Number
1730216961
Provider Name
Idaho Dept Of Health & Welfare Reg 1 Amh Psr Kellogg
Credential
Provider Entity Type
Organization
Address
35 Wildcat Way Ste B, Kellogg, ID, 83837-2261
Phone Number
208-784-1351
Fax Number
208-784-1356
Provider Enumeration Date
02/27/2007
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
HW256 01 BLUE CROSS OF IDAHO
8073520 05 ID
000010018348 01 BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
35 Wildcat Way Ste B
City
State
Zip
83837-2261
Phone Number
208-784-1351
Fax Number
208-784-1356
person
Provider Business Mailing Address Details
Address
35 Wildcat Way Ste B
City
State
Zip
83837-2261
Phone Number
208-784-1351
Fax Number
208-784-1356
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.
()
Definition
Definition to come...
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