| Heritage Family Support Services Of North Idaho | |
|
1270 N Northwood Center Ct Coeur D Alene ID 83814-2664 | |
| (208) 215-2126 | |
| Not Available |
| Full Name | Heritage Family Support Services Of North Idaho |
|---|---|
| Speciality | Clinic/Center |
| Location | 1270 N Northwood Center Ct, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Michael Baker (CEO) |
| Authorized Official Contact | 2086205200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Family Support Services Of North Idaho Po Box 1387 Hayden ID 83835-1387 Ph: () - | Heritage Family Support Services Of North Idaho 1270 N Northwood Center Ct Coeur D Alene ID 83814-2664 Ph: (208) 215-2126 |
| NPI Number | 1255756730 |
|---|---|
| Provider Enumeration Date | 02/20/2014 |
| Last Update Date | 11/14/2023 |
| Certification Date | 11/14/2023 |
| Medicare PECOS PAC ID | 2466353354 |
|---|---|
| Medicare Enrollment ID | O20140611001211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255756730 | NPI | - | NPPES |
| 1378465 | Other | ID | MEDICARE PART B PTAN 1378465 |
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