| Idaho Dept Of Health & Welfare Reg 1 Amh Clinic Cda | |
|
2195 Ironwood Ct Coeur D Alene ID 83814-2628 | |
| (208) 769-1406 | |
| (208) 769-1430 |
| Full Name | Idaho Dept Of Health & Welfare Reg 1 Amh Clinic Cda |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2195 Ironwood Ct, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Cora Jo Gussenhoven (PROGRAM MANAGER) |
| Authorized Official Contact | 2087691406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dept Of Health & Welfare Reg 1 Amh Clinic Cda 2195 Ironwood Ct Coeur D Alene ID 83814-2628 Ph: (208) 769-1406 | Idaho Dept Of Health & Welfare Reg 1 Amh Clinic Cda 2195 Ironwood Ct Coeur D Alene ID 83814-2628 Ph: (208) 769-1406 |
| NPI Number | 1831226547 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831226547 | NPI | - | NPPES |
| 000010018348 | Other | BLUE SHIELD | |
| 8073574 | Medicaid | ID | |
| HW256 | Other | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Ambitions Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1044 Northwest Blvd Ste C, Coeur D Alene, ID 83814 Phone: 208-930-1740 Fax: 208-930-1695 | |
Restored Paths Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 E Harrison Ave, Coeur D Alene, ID 83814 Phone: 208-664-8347 | |
Journey Counseling Of Coeur D'alene Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 Northwest Blvd Ste 101, Coeur D Alene, ID 83814 Phone: 208-953-1403 | |
Cooksey Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 Northwest Blvd Ste 107a, Coeur D Alene, ID 83814 Phone: 208-551-5158 | |
Trauma And Recovery Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E Wallace Ave Ste B, Coeur D Alene, ID 83814 Phone: 801-885-0559 | |
Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2195 Ironwood Ct, Coeur D Alene, ID 83814 Phone: 208-769-1406 Fax: 208-769-1430 | |
North Lakes Family Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 E Lakeside Ave, Coeur D Alene, ID 83814 Phone: 208-664-5941 |