| Eagle Crest Life Services | |
|
416 E Coeur Dalene Ave Coeur D Alene ID 83814-2825 | |
| (208) 666-9162 | |
| Not Available |
| Full Name | Eagle Crest Life Services |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 416 E Coeur Dalene Ave, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Robert Wheeler (PRESIDENT) |
| Authorized Official Contact | 2086669162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Crest Life Services Po Box 3723 Coeur D Alene ID 83816-2529 Ph: () - | Eagle Crest Life Services 416 E Coeur Dalene Ave Coeur D Alene ID 83814-2825 Ph: (208) 666-9162 |
| NPI Number | 1659572493 |
|---|---|
| Provider Enumeration Date | 05/30/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659572493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
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