| Idaho Mental Wellness & Addiction Recovery Pllc | |
|
1516 Primrose Dr Nampa ID 83686-8582 | |
| (208) 697-1075 | |
| (208) 906-8520 |
| Full Name | Idaho Mental Wellness & Addiction Recovery Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1516 Primrose Dr, Nampa, Idaho |
| Authorized Official Name and Position | Scott Watkins (OWNER) |
| Authorized Official Contact | 2086971075 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Mental Wellness & Addiction Recovery Pllc 1516 Primrose Dr Nampa ID 83686-8582 Ph: (208) 697-1075 | Idaho Mental Wellness & Addiction Recovery Pllc 1516 Primrose Dr Nampa ID 83686-8582 Ph: (208) 697-1075 |
| NPI Number | 1750985032 |
|---|---|
| Provider Enumeration Date | 11/26/2020 |
| Last Update Date | 04/07/2021 |
| Certification Date | 04/07/2021 |
| Medicare PECOS PAC ID | 3678981859 |
|---|---|
| Medicare Enrollment ID | O20210428001745 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750985032 | NPI | - | NPPES |
| 60027 | Other | ID | IDAHO BOARD OF NURSING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Scott A Watkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760950604 PECOS PAC ID: 5698017762 Enrollment ID: I20190422001834 |
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