| Idaho Department Of Health & Welfare | |
|
3402 Franklin Rd Caldwell ID 83605-6932 | |
| (208) 459-0092 | |
| (208) 454-7714 |
| Full Name | Idaho Department Of Health & Welfare |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 3402 Franklin Rd, Caldwell, Idaho |
| Authorized Official Name and Position | Todd Hurt (PROGRAM MANAGER) |
| Authorized Official Contact | 2084557057 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Department Of Health & Welfare 3402 Franklin Rd Caldwell ID 83605-6932 Ph: (208) 459-0092 | Idaho Department Of Health & Welfare 3402 Franklin Rd Caldwell ID 83605-6932 Ph: (208) 459-0092 |
| NPI Number | 1144530718 |
|---|---|
| Provider Enumeration Date | 10/18/2010 |
| Last Update Date | 10/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144530718 | NPI | - | NPPES |
| 000010018824 | Other | ID | BLUESHIELD |
| HW348 | Other | ID | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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Idaho Dept Of Health & Welfare Amhcalpgreg3 Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3402 Franklin Rd, Caldwell, ID 83605 Phone: 208-459-0092 Fax: 208-454-7714 |