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211 Coeur D'alene Ave Ste 102 Coeur D'alene ID 83814 | |
(208) 640-0861 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 211 Coeur D'alene Ave Ste 102, Coeur D'alene, Idaho |
Authorized Official Name and Position | Dan Hanks (OWNER) |
Authorized Official Contact | 2086996817 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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211 Coeur D'alene Ave Ste 102 Coeur D'alene ID 83814 Ph: (208) 640-0861 | 211 Coeur D'alene Ave Ste 102 Coeur D'alene ID 83814 Ph: (208) 640-0861 |
NPI Number | 1124466990 |
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Provider Enumeration Date | 06/13/2013 |
Last Update Date | 06/13/2013 |
Identifier | Type | State | Issuer |
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1124466990 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |