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Idaho Dept Of Health & Welfare Reg 6 Cmh Poc Clinic
Adolescent and Children Mental Health Clinic/Center in Pocatello, Idaho
NPI 1780715045

Idaho Dept Of Health & Welfare Reg 6 Cmh Poc Clinic is an Adolescent and Children Mental Health Clinic/Center based in Pocatello, ID and is specialized in Adolescent and Children Mental Health. Idaho Dept Of Health & Welfare Reg 6 Cmh Poc Clinic practices in Pocatello, ID. The NPI Number for Idaho Dept Of Health & Welfare Reg 6 Cmh Poc Clinic is 1780715045 and holds a License No. (Idaho).

The current practice location address for Idaho Dept Of Health & Welfare Reg 6 Cmh Poc Clinic 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
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1780715045
Provider Name
Idaho Dept Of Health & Welfare Reg 6 Cmh Poc Clinic
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
03/08/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
HW157 01 ID BLUE CROSS OF IDAHO
8073651 05 ID
000010019402 01 ID BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
421 Memorial Dr
City
Pocatello
State
Idaho
Zip
83201-4008
Phone Number
208-234-7900
Fax Number
208-236-6328
person
Provider Business Mailing Address Details
Address
421 Memorial Dr
City
Pocatello
State
Idaho
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
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
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Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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