| Maitri Community Services | |
|
3709 N Locust Grove Rd Suite 100 Meridian ID 83646-6449 | |
| (208) 957-5360 | |
| (208) 493-4331 |
| Full Name | Maitri Community Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3709 N Locust Grove Rd, Meridian, Idaho |
| Authorized Official Name and Position | Lori Nicole Eaton (OWNER/PROVIDER) |
| Authorized Official Contact | 2089575360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maitri Community Services 3709 N Locust Grove Rd Suite 100 Meridian ID 83646-6449 Ph: (208) 957-5360 | Maitri Community Services 3709 N Locust Grove Rd Suite 100 Meridian ID 83646-6449 Ph: (208) 957-5360 |
| NPI Number | 1306299805 |
|---|---|
| Provider Enumeration Date | 07/20/2016 |
| Last Update Date | 07/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306299805 | NPI | - | NPPES |
| 806968300 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 31259 (Idaho) | Primary |
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