| Mindful Moments Llc | |
|
15636 N Highway 41 Ste 700 Rathdrum ID 83858-8710 | |
| (208) 771-1054 | |
| (208) 712-6809 |
| Full Name | Mindful Moments Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 15636 N Highway 41 Ste 700, Rathdrum, Idaho |
| Authorized Official Name and Position | Lea B Harger (OWNER) |
| Authorized Official Contact | 2087711054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Moments Llc 13734 W Winch Ave Rathdrum ID 83858-7621 Ph: () - | Mindful Moments Llc 15636 N Highway 41 Ste 700 Rathdrum ID 83858-8710 Ph: (208) 771-1054 |
| NPI Number | 1811502313 |
|---|---|
| Provider Enumeration Date | 09/10/2020 |
| Last Update Date | 09/10/2020 |
| Certification Date | 09/10/2020 |
| Medicare PECOS PAC ID | 1052739166 |
|---|---|
| Medicare Enrollment ID | O20200922000098 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811502313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Lea B Harger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851583389 PECOS PAC ID: 4385949445 Enrollment ID: I20160226001561 |
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