| Res Hab Behavior Consultation | |
|
4806 Hawthorne Rd Chubbuck ID 83202-2325 | |
| (208) 233-0016 | |
| (208) 234-2755 |
| Full Name | Res Hab Behavior Consultation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4806 Hawthorne Rd, Chubbuck, Idaho |
| Authorized Official Name and Position | Jason Mcarthur (CFO) |
| Authorized Official Contact | 5033625235 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Res Hab Behavior Consultation 3155 River Rd S Ste 100 Salem OR 97302-9819 Ph: (503) 362-5235 | Res Hab Behavior Consultation 4806 Hawthorne Rd Chubbuck ID 83202-2325 Ph: (208) 233-0016 |
| NPI Number | 1497069132 |
|---|---|
| Provider Enumeration Date | 08/05/2010 |
| Last Update Date | 08/05/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497069132 | NPI | - | NPPES |
| 806703800 | Medicaid | ID | |
| M8067038 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 000681691 (Idaho) | Primary |
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