Bright Tomorrows, Incorporated | |
409 Washington Ave Pocatello ID 83201-4520 | |
(208) 234-2646 | |
(208) 232-0035 |
Full Name | Bright Tomorrows, Incorporated |
---|---|
Speciality | Clinic/center - Adolescent And Children Mental Health |
Location | 409 Washington Ave, Pocatello, Idaho |
Authorized Official Name and Position | Cassidy Michelle Roske (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2082342646 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Bright Tomorrows, Incorporated 409 Washington Ave Pocatello ID 83201-4520 Ph: (208) 234-2646 | Bright Tomorrows, Incorporated 409 Washington Ave Pocatello ID 83201-4520 Ph: (208) 234-2646 |
NPI Number | 1619177797 |
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Provider Enumeration Date | 07/18/2007 |
Last Update Date | 08/13/2024 |
Certification Date | 08/13/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619177797 | NPI | - | NPPES |
8082288 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | LPC 870/LCPC 724 (Idaho) | Secondary |
261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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