Pacific Mental Health Idaho Llc | |
1617 Cleveland Blvd Caldwell ID 83605-5029 | |
(425) 582-2041 | |
(425) 527-0468 |
Full Name | Pacific Mental Health Idaho Llc |
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Speciality | Counselor - Mental Health |
Location | 1617 Cleveland Blvd, Caldwell, Idaho |
Authorized Official Name and Position | Jessy Hoag (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 4253612273 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pacific Mental Health Idaho Llc 5108 196th St Sw Ste 350 C/o Rxdx Medical Billing Services Llc, Ste 310 Lynnwood WA 98036-6169 Ph: (425) 361-2273 | Pacific Mental Health Idaho Llc 1617 Cleveland Blvd Caldwell ID 83605-5029 Ph: (425) 582-2041 |
NPI Number | 1710667142 |
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Provider Enumeration Date | 07/20/2023 |
Last Update Date | 07/20/2023 |
Certification Date | 07/20/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710667142 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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