| Summit View Wellness Services, Llc | |
|
1070 Hiline Rd Ste 210 Pocatello ID 83201-2947 | |
| (208) 262-4209 | |
| (208) 262-4318 |
| Full Name | Summit View Wellness Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1070 Hiline Rd Ste 210, Pocatello, Idaho |
| Authorized Official Name and Position | Trent P Turner (MEMBER) |
| Authorized Official Contact | 2082624209 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit View Wellness Services, Llc 1070 Hiline Rd Ste 210 Pocatello ID 83201-2947 Ph: (208) 262-4209 | Summit View Wellness Services, Llc 1070 Hiline Rd Ste 210 Pocatello ID 83201-2947 Ph: (208) 262-4209 |
| NPI Number | 1821673716 |
|---|---|
| Provider Enumeration Date | 03/12/2021 |
| Last Update Date | 06/01/2022 |
| Certification Date | 05/17/2022 |
| Medicare PECOS PAC ID | 8224446471 |
|---|---|
| Medicare Enrollment ID | O20210428000826 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821673716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Trent P Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184861650 PECOS PAC ID: 4688842982 Enrollment ID: I20110712000263 |
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