| State Avenue Offices | |
|
39 E State Ave Meridian ID 83642-2342 | |
| (208) 994-3599 | |
| (208) 473-2206 |
| Full Name | State Avenue Offices |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 39 E State Ave, Meridian, Idaho |
| Authorized Official Name and Position | Camilla J Cafferty (OWNER) |
| Authorized Official Contact | 2089943599 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Avenue Offices 39 E State Ave Meridian ID 83642-2342 Ph: (208) 994-3599 | State Avenue Offices 39 E State Ave Meridian ID 83642-2342 Ph: (208) 994-3599 |
| NPI Number | 1821344367 |
|---|---|
| Provider Enumeration Date | 08/02/2012 |
| Last Update Date | 10/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821344367 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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