| Men's Second Chance Living | |
|
400 S Main St Ste 304b Hailey ID 83333-8875 | |
| (208) 481-1018 | |
| Not Available |
| Full Name | Men's Second Chance Living |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 400 S Main St Ste 304b, Hailey, Idaho |
| Authorized Official Name and Position | Sonya Wilander (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2084810182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Men's Second Chance Living Po Box 2398 Hailey ID 83333-2398 Ph: (208) 481-0182 | Men's Second Chance Living 400 S Main St Ste 304b Hailey ID 83333-8875 Ph: (208) 481-1018 |
| NPI Number | 1558108670 |
|---|---|
| Provider Enumeration Date | 07/15/2024 |
| Last Update Date | 07/15/2024 |
| Certification Date | 07/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558108670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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