| Idaho Dept Of Health & Welfare Reg 2 Cmh | |
|
216 S C St Grangeville ID 83530-1342 | |
| (208) 983-2300 | |
| Not Available |
| Full Name | Idaho Dept Of Health & Welfare Reg 2 Cmh |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 216 S C St, Grangeville, Idaho |
| Authorized Official Name and Position | Vicki Malone (PROGRAM MANAGER) |
| Authorized Official Contact | 2087994440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dept Of Health & Welfare Reg 2 Cmh Po Box 548 Grangeville ID 83530-0548 Ph: (208) 983-2300 | Idaho Dept Of Health & Welfare Reg 2 Cmh 216 S C St Grangeville ID 83530-1342 Ph: (208) 983-2300 |
| NPI Number | 1407153737 |
|---|---|
| Provider Enumeration Date | 02/23/2011 |
| Last Update Date | 02/23/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407153737 | NPI | - | NPPES |
| 000010018450 | Other | ID | BLUE SHIELD |
| HW140 | Other | ID | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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Idaho Dept Of Health & Welfare Reg 2 Amh Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 216 S C St, Grangeville, ID 83530 Phone: 208-983-2300 | |
Idaho Dept Of Health & Welfare Reg Ii Amh Grangeville Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 216 S C St, Grangeville, ID 83530 Phone: 208-983-2300 Fax: 208-983-2440 |