| Idaho Dept Of Health & Welfare R5 Amh Cl | |
|
823 Harrison St Twin Falls ID 83301-3925 | |
| (208) 736-2177 | |
| Not Available |
| Full Name | Idaho Dept Of Health & Welfare R5 Amh Cl |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 823 Harrison St, Twin Falls, Idaho |
| Authorized Official Name and Position | Duke Morton (FIELD SERVICES PROGRAM MANAGER) |
| Authorized Official Contact | 2087362177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dept Of Health & Welfare R5 Amh Cl 823 Harrison St Twin Falls ID 83301-3925 Ph: () - | Idaho Dept Of Health & Welfare R5 Amh Cl 823 Harrison St Twin Falls ID 83301-3925 Ph: (208) 736-2177 |
| NPI Number | 1720119225 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720119225 | NPI | - | NPPES |
| 000010025421 | Other | ID | BLUESHIELD |
| HW173 | Other | ID | BLUE CROSS |
| 0028319 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (Idaho) | Primary |
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