Human Supports Of Idaho | |
314 Badiola St Caldwell ID 83605-4389 | |
(208) 454-8389 | |
(208) 454-8404 |
Full Name | Human Supports Of Idaho |
---|---|
Speciality | Nurse Practitioner - Psychiatric/mental Health |
Location | 314 Badiola St, Caldwell, Idaho |
Authorized Official Name and Position | Alita Ruby (ADMINISTRATIVE SERVICE MANAGER) |
Authorized Official Contact | 2084548389 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Human Supports Of Idaho Po Box 820 Caldwell ID 83606-0820 Ph: (208) 454-8389 | Human Supports Of Idaho 314 Badiola St Caldwell ID 83605-4389 Ph: (208) 454-8389 |
NPI Number | 1700129491 |
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Provider Enumeration Date | 04/01/2013 |
Last Update Date | 03/08/2023 |
Certification Date | 03/08/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700129491 | NPI | - | NPPES |
20002419 | Other | ID | MEDICARE PTAN |
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