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651 S Beverly St Shoshone ID 83352 | |
| (208) 886-2224 | |
| (208) 886-2634 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 651 S Beverly St, Shoshone, Idaho |
| Authorized Official Name and Position | Stacey Blackwood (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2087376718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
794 Eastland Dr Twin Falls ID 83301-6856 Ph: (208) 737-6718 | 651 S Beverly St Shoshone ID 83352 Ph: (208) 886-2224 |
| NPI Number | 1841932498 |
|---|---|
| Provider Enumeration Date | 04/12/2022 |
| Last Update Date | 10/28/2024 |
| Certification Date | 10/28/2024 |
| Medicare PECOS PAC ID | 7012815038 |
|---|---|
| Medicare Enrollment ID | O20220819001301 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841932498 | NPI | - | NPPES |
Family Health Services Corporation Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 61 E Highway 24, Shoshone, ID 83352 Phone: 208-886-2381 | |
Lincoln Community Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 South Apple Street, Shoshone, ID 83352 Phone: 208-886-2224 Fax: 208-886-2634 |