Idaho Dept Of Health & Welfare Amh Psr Boise

NPI 1205966157 - Clinic/Center - 261QM0801X

NPI Details
NPI 1205966157
Enumeration Date 03/07/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name GINA GINA
Position PROGRAM MANAGER
Phone (208) 334-0894
Fax (208) 334-0804
Practice Location
1720 WESTGATE DR
SUITE B-1
BOISE ID, 83704-7164, US
Phone (208) 334-0894
Fax (208) 334-0804
Business Location
1720 WESTGATE DR
SUITE B-1
BOISE ID, 83704-7164, US
Phone (208) 334-0894
Fax (208) 334-0804
Toxanomy
Taxonomy Code 261QM0801X
License State
License Number
Remove 1205966157 NPI Number
 

According to our database, Idaho Dept Of Health & Welfare Amh Psr Boise NPI is 1205966157, taxonomy code is 261QM0801X Idaho Dept Of Health & Welfare Amh Psr Boise physically located at 1720 Westgate Dr, Boise ID, 83704-7164. NPI Number 1033115704 has the healthcare provider type.

1205966157 NPI number is provided on an as is basis without warranty of any kind. 1205966157 is maintained by the National Plan & Provider Enumeration System. The contents of Idaho Dept Of Health & Welfare Amh Psr Boise are for informational purposes only.