| Idaho Dept. Of Health & Welfare | |
|
2241 Overland Ave. Burley ID 83318-2929 | |
| (208) 677-5390 | |
| (208) 677-4002 |
| Full Name | Idaho Dept. Of Health & Welfare |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2241 Overland Ave., Burley, Idaho |
| Authorized Official Name and Position | Scott Rasmussen (HUMAN SERVICES FIELD PROGRAM MANAGE) |
| Authorized Official Contact | 2087321601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dept. Of Health & Welfare 2241 Overland Ave. Burley ID 83318-2929 Ph: (208) 677-5390 | Idaho Dept. Of Health & Welfare 2241 Overland Ave. Burley ID 83318-2929 Ph: (208) 677-5390 |
| NPI Number | 1033240296 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 01/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033240296 | NPI | - | NPPES |
| 000010025421 | Other | ID | BLUE SHIELD |
| 8073513 | Medicaid | ID | |
| HW173 | Other | ID | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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