| Core Dynamics Llc | |
|
615 Royal St Caldwell ID 83605-1663 | |
| (208) 501-6361 | |
| Not Available |
| Full Name | Core Dynamics Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 615 Royal St, Caldwell, Idaho |
| Authorized Official Name and Position | Kristene Blair (ADMINISTRATOR) |
| Authorized Official Contact | 2085016361 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Core Dynamics Llc 615 Royal St Caldwell ID 83605-1663 Ph: (208) 501-6361 | Core Dynamics Llc 615 Royal St Caldwell ID 83605-1663 Ph: (208) 501-6361 |
| NPI Number | 1144913252 |
|---|---|
| Provider Enumeration Date | 06/02/2023 |
| Last Update Date | 06/02/2023 |
| Certification Date | 06/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144913252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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