| Angel Wings Center Of Healing | |
|
477 Shoup Ave Ste 107b Idaho Falls ID 83402-3658 | |
| (208) 522-1914 | |
| (208) 522-1956 |
| Full Name | Angel Wings Center Of Healing |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 477 Shoup Ave Ste 107b, Idaho Falls, Idaho |
| Authorized Official Name and Position | Bobette R Page (OWNER-MANAGER) |
| Authorized Official Contact | 2087570330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Wings Center Of Healing 477 Shoup Ave Ste 107b Idaho Falls ID 83402-3658 Ph: (208) 522-1914 | Angel Wings Center Of Healing 477 Shoup Ave Ste 107b Idaho Falls ID 83402-3658 Ph: (208) 522-1914 |
| NPI Number | 1497962575 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 12/31/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497962575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LCSW-27373 (Idaho) | Primary |
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