| Midlife Center | |
|
1423 N Government Way Coeur D Alene ID 83814-3335 | |
| (208) 691-2515 | |
| (208) 665-2398 |
| Full Name | Midlife Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1423 N Government Way, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Julie Kay Boothe (BILLER) |
| Authorized Official Contact | 2087655656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midlife Center 912 N Balcony Dr Coeur D Alene ID 83814-6899 Ph: (208) 691-2515 | Midlife Center 1423 N Government Way Coeur D Alene ID 83814-3335 Ph: (208) 691-2515 |
| NPI Number | 1336466994 |
|---|---|
| Provider Enumeration Date | 04/22/2010 |
| Last Update Date | 04/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336466994 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW29348 (Idaho) | Primary |
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