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2426 N Merritt Creek Loop, Suite B Obot Room #100 Coeur D'alene ID 83814-4961 | |
(208) 296-5385 | |
(208) 296-5387 |
Full Name | |
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Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 2426 N Merritt Creek Loop, Suite B, Coeur D'alene, Idaho |
Authorized Official Name and Position | Zack Ragsdale (DIRECTOR) |
Authorized Official Contact | 5124545911 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5001 Spring Valley Road Suite 600 East Dallas TX 75244-3946 Ph: (214) 365-6100 | 2426 N Merritt Creek Loop, Suite B Obot Room #100 Coeur D'alene ID 83814-4961 Ph: (208) 296-5385 |
NPI Number | 1235844820 |
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Provider Enumeration Date | 01/18/2023 |
Last Update Date | 09/23/2024 |
Certification Date | 09/23/2024 |
Identifier | Type | State | Issuer |
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1235844820 | NPI | - | NPPES |