| Fulfilling Hope Human Services Llc | |
|
15464 N Vernon St Rathdrum ID 83858-8363 | |
| (208) 252-5235 | |
| (208) 292-6661 |
| Full Name | Fulfilling Hope Human Services Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 15464 N Vernon St, Rathdrum, Idaho |
| Authorized Official Name and Position | Andrea Mcclure (OWNER) |
| Authorized Official Contact | 2082525235 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fulfilling Hope Human Services Llc Po Box 184 Rathdrum ID 83858-0184 Ph: (208) 252-5235 | Fulfilling Hope Human Services Llc 15464 N Vernon St Rathdrum ID 83858-8363 Ph: (208) 252-5235 |
| NPI Number | 1740051325 |
|---|---|
| Provider Enumeration Date | 01/11/2024 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740051325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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