| Ala, Llc | |
|
818 E Lander Pocatello ID 83201 | |
| (208) 234-2094 | |
| (208) 234-2637 |
| Full Name | Ala, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 818 E Lander, Pocatello, Idaho |
| Authorized Official Name and Position | Cheri L Atkins (CEO/PSYCHOLOGIST) |
| Authorized Official Contact | 2082342094 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ala, Llc 818 E Lander Pocatello ID 83201 Ph: (208) 234-2094 | Ala, Llc 818 E Lander Pocatello ID 83201 Ph: (208) 234-2094 |
| NPI Number | 1588810535 |
|---|---|
| Provider Enumeration Date | 08/11/2008 |
| Last Update Date | 03/19/2014 |
| Medicare PECOS PAC ID | 1254550494 |
|---|---|
| Medicare Enrollment ID | O20140919001432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588810535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PSY-202272 (Idaho) | Primary |
| Provider Name | Cheri Atkins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639218241 PECOS PAC ID: 2961621107 Enrollment ID: I20150526002428 |
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