Fulfillment Llc | |
14331 Crego St Caldwell ID 83607-4815 | |
(208) 284-7233 | |
Not Available |
Full Name | Fulfillment Llc |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 14331 Crego St, Caldwell, Idaho |
Authorized Official Name and Position | Kendra Jean Nielson (MANAGER) |
Authorized Official Contact | 2082847233 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Fulfillment Llc 14331 Crego St Caldwell ID 83607-4815 Ph: (208) 757-0067 | Fulfillment Llc 14331 Crego St Caldwell ID 83607-4815 Ph: (208) 284-7233 |
NPI Number | 1679287296 |
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Provider Enumeration Date | 01/09/2023 |
Last Update Date | 01/09/2023 |
Certification Date | 01/09/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679287296 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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