| Idaho Dept Of Health & Welfare Reg 7 Amh Bf | |
|
720 E Alice Blackfoot ID 83221-0129 | |
| (208) 785-5871 | |
| (208) 785-5877 |
| Full Name | Idaho Dept Of Health & Welfare Reg 7 Amh Bf |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 720 E Alice, Blackfoot, Idaho |
| Authorized Official Name and Position | Randy Rodriquez (PROGRAM MANAGER) |
| Authorized Official Contact | 2085285700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dept Of Health & Welfare Reg 7 Amh Bf 720 E Alice Po Box 129 Blackfoot ID 83221-0129 Ph: (208) 785-5871 | Idaho Dept Of Health & Welfare Reg 7 Amh Bf 720 E Alice Blackfoot ID 83221-0129 Ph: (208) 785-5871 |
| NPI Number | 1114058179 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 08/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114058179 | NPI | - | NPPES |
| 8073683 | Medicaid | ID | |
| 000010019479 | Other | ID | BLUE SHIELD |
| HW181 | Other | ID | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
United Family Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 W Bridge St, Blackfoot, ID 83221 Phone: 208-200-9515 | |
State Hospital South Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 E Alice St, Blackfoot, ID 83221 Phone: 208-785-8506 Fax: 208-785-8518 | |
A To Z Family Services Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 150 S Broadway St, Blackfoot, ID 83221 Phone: 208-785-1326 Fax: 208-785-1396 | |
J&m Mental Health, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 60 N Broadway St, Blackfoot, ID 83221 Phone: 208-782-1102 | |
J&m Mental Health, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 60 N Broadway St, Blackfoot, ID 83221 Phone: 208-782-1102 | |
Blackfoot Medical Clinic Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 |