Idaho Dept Of Health & Welfare Esc Region 2

NPI 1215079777 - Case Management - 251B00000X

NPI Details
NPI 1215079777
Enumeration Date 02/13/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARY J MARY
Position PROGRAM MANAGER
Phone (208) 799-3460
Fax (208) 799-3466
Practice Location
2604 16TH AVE
LEWISTON ID, 83501-3539, US
Phone (208) 799-3460
Fax (208) 799-3466
Business Location
1118 F ST
PO DRAWER B
LEWISTON ID, 83501-1930, US
Phone (208) 799-3460
Fax (208) 799-3466
Toxanomy
Taxonomy Code 251B00000X
License State
License Number
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According to our database, Idaho Dept Of Health & Welfare Esc Region 2 NPI is 1215079777, taxonomy code is 251B00000X Idaho Dept Of Health & Welfare Esc Region 2 physically located at 2604 16th Ave, Lewiston ID, 83501-3539. NPI Number 1033115704 has the healthcare provider type.

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1215079777 NPI number is provided on an as is basis without warranty of any kind. 1215079777 is maintained by the National Plan & Provider Enumeration System. The contents of Idaho Dept Of Health & Welfare Esc Region 2 are for informational purposes only.