| Idaho Dept Of Health & Welfare Reg Ii Amh Moscow | |
|
1350 Troy Hwy Moscow ID 83843-3995 | |
| (208) 882-0562 | |
| (208) 882-8575 |
| Full Name | Idaho Dept Of Health & Welfare Reg Ii Amh Moscow |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1350 Troy Hwy, Moscow, Idaho |
| Authorized Official Name and Position | Vicki R. 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 Ii Amh Moscow 1350 Troy Hwy Moscow ID 83843-3995 Ph: (208) 882-0562 | Idaho Dept Of Health & Welfare Reg Ii Amh Moscow 1350 Troy Hwy Moscow ID 83843-3995 Ph: (208) 882-0562 |
| NPI Number | 1326176132 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326176132 | NPI | - | NPPES |
| 8073803 | Medicaid | ID | |
| HW264 | Other | BLUE CROSS OF IDAHO | |
| 000010018440 | Other | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Clearwater Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 West 4th #5, Moscow, ID 83843 Phone: 208-882-9460 Fax: 208-746-7402 | |
Syzygy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 676 W Pullman Rd, #235, Moscow, ID 83843 Phone: 208-874-7969 | |
Sequel Alliance Family Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 Rodeo Dr, Moscow, ID 83843 Phone: 208-882-5960 Fax: 208-882-0857 | |
Integrative Mindworks Llc, April King Rubino Sole Mbr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 803 S Jefferson St, Suite 3, Moscow, ID 83843 Phone: 208-882-8159 | |
Region Ii Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1350 Troy Rd, Moscow, ID 83843 Phone: 208-882-0562 Fax: 208-882-8575 | |
Alliance Family Services North, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 Rodeo Dr, Suite 410, Moscow, ID 83843 Phone: 208-882-5960 | |
Gritman Psychiatric Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 803 S Main St Ste 210, Moscow, ID 83843 Phone: 208-883-6774 Fax: 208-883-1398 |