| Madison Memorial Behavioral Health Unit | |
|
450 E Main St Rexburg ID 83440-2048 | |
| (208) 359-6900 | |
| Not Available |
| Full Name | Madison Memorial Behavioral Health Unit |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 450 E Main St, Rexburg, Idaho |
| Authorized Official Name and Position | Rachel Gonzales (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2083596900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Madison Memorial Behavioral Health Unit Po Box 700 Rexburg ID 83440-0700 Ph: (208) 359-6900 | Madison Memorial Behavioral Health Unit 450 E Main St Rexburg ID 83440-2048 Ph: (208) 359-6900 |
| NPI Number | 1932864642 |
|---|---|
| Provider Enumeration Date | 11/08/2021 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Medicare PECOS PAC ID | 8123016367 |
|---|---|
| Medicare Enrollment ID | O20210728003542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932864642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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