| St. Alphonsus Eap | |
|
6140 W Emerald St Boise ID 83704 | |
| (208) 367-3300 | |
| (208) 367-3308 |
| Full Name | St. Alphonsus Eap |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 6140 W Emerald St, Boise, Idaho |
| Authorized Official Name and Position | Brian Lannie Checketts (CFO) |
| Authorized Official Contact | 2083677347 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Alphonsus Eap 6140 W Emerald St Boise ID 83704-8857 Ph: (208) 367-3300 | St. Alphonsus Eap 6140 W Emerald St Boise ID 83704 Ph: (208) 367-3300 |
| NPI Number | 1699890574 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 01/24/2023 |
| Certification Date | 01/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699890574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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