| Eastport Psr, L.l.p. | |
|
7222 Main Street Bonners Ferry ID 83805 | |
| (208) 946-3604 | |
| (208) 267-1681 |
| Full Name | Eastport Psr, L.l.p. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7222 Main Street, Bonners Ferry, Idaho |
| Authorized Official Name and Position | Anna Lee Harris (PSYCHOSOCIAL REHABILITATION SPECIAL) |
| Authorized Official Contact | 12082677290 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastport Psr, L.l.p. Po Box 1093 Bonners Ferry ID 83805-1093 Ph: (208) 946-3604 | Eastport Psr, L.l.p. 7222 Main Street Bonners Ferry ID 83805 Ph: (208) 946-3604 |
| NPI Number | 1083831556 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083831556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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