| Kootenai Health, Inc. | |
|
2003 Kootenai Health Way Coeur D Alene ID 83814-6051 | |
| (208) 625-4000 | |
| (208) 625-5731 |
| Full Name | Kootenai Health, Inc. |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 2003 Kootenai Health Way, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Jon Ness (CEO) |
| Authorized Official Contact | 2086255081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kootenai Health, Inc. 2003 Kootenai Health Way Coeur D Alene ID 83814-6051 Ph: (208) 625-4000 | Kootenai Health, Inc. 2003 Kootenai Health Way Coeur D Alene ID 83814-6051 Ph: (208) 625-4000 |
| NPI Number | 1568567360 |
|---|---|
| Provider Enumeration Date | 09/14/2006 |
| Last Update Date | 01/05/2024 |
| Certification Date | 01/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568567360 | NPI | - | NPPES |
| 805183600 | Medicaid | ID | |
| 000010004925 | Other | ID | REGENCE BLUE SHIELD |
| 01008 | Other | ID | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 42 (Idaho) | Primary |
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