| Spectrum Connection Behavioral Health Llc | |
|
1315 Highway 2 Ste 4 Sandpoint ID 83864-2724 | |
| (208) 261-2740 | |
| (208) 625-2062 |
| Full Name | Spectrum Connection Behavioral Health Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1315 Highway 2 Ste 4, Sandpoint, Idaho |
| Authorized Official Name and Position | Cynthia D Ruguleiski (OWNER/PROVIDER) |
| Authorized Official Contact | 2082612740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spectrum Connection Behavioral Health Llc 1315 Highway 2 Ste 4 Sandpoint ID 83864-2724 Ph: (208) 261-2740 | Spectrum Connection Behavioral Health Llc 1315 Highway 2 Ste 4 Sandpoint ID 83864-2724 Ph: (208) 261-2740 |
| NPI Number | 1558076513 |
|---|---|
| Provider Enumeration Date | 01/13/2023 |
| Last Update Date | 01/09/2024 |
| Certification Date | 01/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558076513 | NPI | - | NPPES |
| 806106400 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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