| Candlewood Family Counseling Center, Inc. | |
|
335 N Main St Pocatello ID 83204-3108 | |
| (208) 478-8340 | |
| (208) 478-8341 |
| Full Name | Candlewood Family Counseling Center, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 335 N Main St, Pocatello, Idaho |
| Authorized Official Name and Position | Ella C Dingman (PRESIDENT, MANAGER) |
| Authorized Official Contact | 2084788340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Candlewood Family Counseling Center, Inc. 335 N Main St Po Box 2306 Pocatello ID 83204-3108 Ph: (208) 478-8340 | Candlewood Family Counseling Center, Inc. 335 N Main St Pocatello ID 83204-3108 Ph: (208) 478-8340 |
| NPI Number | 1760688584 |
|---|---|
| Provider Enumeration Date | 06/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760688584 | NPI | - | NPPES |
| 8059487 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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