| Idaho Dept Of Health & Welfare Amh Clinic Mh | |
|
2420 American Legion Blvd Mountain Home ID 83647-3146 | |
| (208) 587-9061 | |
| (208) 587-5024 |
| Full Name | Idaho Dept Of Health & Welfare Amh Clinic Mh |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2420 American Legion Blvd, Mountain Home, Idaho |
| Authorized Official Name and Position | Gina Westcott (PROGRAM MANAGER) |
| Authorized Official Contact | 2083340969 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dept Of Health & Welfare Amh Clinic Mh 1720 Westgate Dr Suite B-1 Boise ID 83704-7164 Ph: (208) 334-0894 | Idaho Dept Of Health & Welfare Amh Clinic Mh 2420 American Legion Blvd Mountain Home ID 83647-3146 Ph: (208) 587-9061 |
| NPI Number | 1760512644 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760512644 | NPI | - | NPPES |
| 8075987 | Medicaid | ID | |
| HW280 | Other | BLUE CROSS OF IDAHO | |
| 000010018973 | Other | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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