| Idaho Dept Of Health & Welfare Reg 1 Amh Psr Bonners Ferry | |
|
Rt 4 6522 Tamarack Ln Bonners Ferry ID 83805-9805 | |
| (208) 267-3187 | |
| (208) 267-3251 |
| Full Name | Idaho Dept Of Health & Welfare Reg 1 Amh Psr Bonners Ferry |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | Rt 4 6522 Tamarack Ln, Bonners Ferry, 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 Psr Bonners Ferry Rt 4 6522 Tamarack Ln Bonners Ferry ID 83805-9805 Ph: (208) 267-3187 | Idaho Dept Of Health & Welfare Reg 1 Amh Psr Bonners Ferry Rt 4 6522 Tamarack Ln Bonners Ferry ID 83805-9805 Ph: (208) 267-3187 |
| NPI Number | 1376670091 |
|---|---|
| Provider Enumeration Date | 02/28/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376670091 | NPI | - | NPPES |
| 8073521 | Medicaid | ID | |
| 000010018348 | Other | BLUE SHIELD | |
| HW256 | Other | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Eastport Psr, L.l.p. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7222 Main Street, Bonners Ferry, ID 83805 Phone: 208-946-3604 Fax: 208-267-1681 | |
Playworks Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7583 Main St, Hawkins House Healing Center, Bonners Ferry, ID 83805 Phone: 208-946-9572 Fax: 208-267-9020 | |
Rachel Meiland Webster Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6686 Augusta Bldg 100, Bonners Ferry, ID 83805 Phone: 208-946-0001 Fax: 208-267-1922 | |
Si Thompson Lcsw Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7167 1st St Unit 465, Bonners Ferry, ID 83805 Phone: 208-290-4944 | |
Sequel Alliance Family Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6334 Main St, Bonners Ferry, ID 83805 Phone: 208-267-0780 Fax: 208-267-7941 | |
Rawlings Community Counseling Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6807 Cody St, Bonners Ferry, ID 83805 Phone: 208-267-0900 Fax: 208-267-6100 | |
Sweetwater Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 720 Chute Canyon Way, Bonners Ferry, ID 83805 Phone: 208-610-2980 |