Mountain States Group, Inc. | |
1607 W Jefferson St Boise ID 83702-5111 | |
(208) 336-5533 | |
(208) 947-4290 |
Full Name | Mountain States Group, Inc. |
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Speciality | Community/behavioral Health |
Location | 1607 W Jefferson St, Boise, Idaho |
Authorized Official Name and Position | Hartzell Cobbs (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2083365533 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mountain States Group, Inc. 1607 W Jefferson St Boise ID 83702-5111 Ph: (208) 336-5533 | Mountain States Group, Inc. 1607 W Jefferson St Boise ID 83702-5111 Ph: (208) 336-5533 |
NPI Number | 1750594032 |
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Provider Enumeration Date | 05/07/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750594032 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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