| Res Hab Behavior Consultation | |
|
440 W Pennwood St Ste 200 Meridian ID 83642-8602 | |
| (208) 855-9148 | |
| (208) 884-2164 |
| Full Name | Res Hab Behavior Consultation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 440 W Pennwood St Ste 200, Meridian, 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 440 W Pennwood St Ste 200 Meridian ID 83642-8602 Ph: (208) 855-9148 |
| NPI Number | 1689989816 |
|---|---|
| Provider Enumeration Date | 08/12/2010 |
| Last Update Date | 08/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689989816 | NPI | - | NPPES |
| 806849800 | Medicaid | ID | |
| M8068498-001 | Medicaid | ID | |
| M8068498 | Medicaid | ID | |
| M8068498-002 | Medicaid | ID | |
| 806849802 | Medicaid | ID | |
| 806849801 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 001036235 (Idaho) | Primary |
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