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120 S 13th St St Maries ID 83861-1627 | |
| (208) 245-4363 | |
| (208) 245-4349 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 120 S 13th St, St Maries, Idaho |
| Authorized Official Name and Position | Mike 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 |
|---|---|
Po Box 1387 Hayden ID 83835-1387 Ph: (208) 620-5200 | 120 S 13th St St Maries ID 83861-1627 Ph: (208) 245-4363 |
| NPI Number | 1568910156 |
|---|---|
| Provider Enumeration Date | 09/13/2016 |
| Last Update Date | 12/30/2024 |
| Certification Date | 12/30/2024 |
| Medicare PECOS PAC ID | 2466353354 |
|---|---|
| Medicare Enrollment ID | O20170321002374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568910156 | NPI | - | NPPES |
Idaho Dept Of Health & Welfare Reg 1 Amh Psr St Maries Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 222 S 7th St, St Maries, ID 83861 Phone: 208-245-2541 Fax: 208-245-7131 | |
Sequel Alliance Family Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 89 Homer Dr, St Maries, ID 83861 Phone: 208-245-5427 Fax: 208-245-5427 | |
Lone Pine Behavioral Health Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1030 S 3rd St, St Maries, ID 83861 Phone: 208-274-3430 | |
Alliance Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 89 Homer Dr, St Maries, ID 83861 Phone: 208-245-5427 |