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911 S Highway 30 Heyburn ID 83336-5001 | |
(208) 679-2273 | |
(208) 679-3368 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 911 S Highway 30, Heyburn, Idaho |
Authorized Official Name and Position | Sally Hall (PRESIDENT) |
Authorized Official Contact | 2086703116 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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911 S Highway 30 Heyburn ID 83336-5001 Ph: (208) 679-2273 | 911 S Highway 30 Heyburn ID 83336-5001 Ph: (208) 679-2273 |
NPI Number | 1518267897 |
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Provider Enumeration Date | 11/02/2010 |
Last Update Date | 11/02/2010 |
Identifier | Type | State | Issuer |
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1518267897 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 17053195340039 (Idaho) | Primary |