| Eagle Crest Life Services, Inc. | |
|
212 S 11th St Ste. 3 Coeur D Alene ID 83814-4000 | |
| (208) 666-9162 | |
| (208) 769-9321 |
| Full Name | Eagle Crest Life Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 212 S 11th St, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Robert Wheeler (PRESIDENT) |
| Authorized Official Contact | 2086669162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Crest Life Services, Inc. Po Box 3723 Coeur D Alene ID 83816-2529 Ph: (208) 666-9162 | Eagle Crest Life Services, Inc. 212 S 11th St Ste. 3 Coeur D Alene ID 83814-4000 Ph: (208) 666-9162 |
| NPI Number | 1659492429 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 03/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659492429 | NPI | - | NPPES |
| 807602900 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 807602900 (Idaho) | Primary |
Ambitions Of Idaho, Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1044 Northwest Blvd Ste C, Coeur D Alene, ID 83814 Phone: 208-930-1740 Fax: 208-930-1695 | |
Restored Paths Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 E Harrison Ave, Coeur D Alene, ID 83814 Phone: 208-664-8347 | |
Journey Counseling Of Coeur D'alene Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 Northwest Blvd Ste 101, Coeur D Alene, ID 83814 Phone: 208-953-1403 | |
Cooksey Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 Northwest Blvd Ste 107a, Coeur D Alene, ID 83814 Phone: 208-551-5158 | |
Line Of Courage Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 296 W Sunset Ave Ste 15, Coeur D Alene, ID 83815 Phone: 208-666-0357 | |
Trauma And Recovery Counseling Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E Wallace Ave Ste B, Coeur D Alene, ID 83814 Phone: 801-885-0559 | |
Idaho Dept Of Health & Welfare Reg 1 Amh Psr Cda Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2195 Ironwood Ct, Coeur D Alene, ID 83814 Phone: 208-769-1406 Fax: 208-769-1430 |