| Idaho Dept Of Health & Welfare Amh Psr Mt Home | |
|
2420 American Legion Blvd Mountain Home ID 83647-3146 | |
| (208) 587-9061 | |
| (208) 587-5024 |
| Full Name | Idaho Dept Of Health & Welfare Amh Psr Mt Home |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2420 American Legion Blvd, Mountain Home, Idaho |
| Authorized Official Name and Position | Gina Westcott (PROGRAM MANAGER) |
| Authorized Official Contact | 2083340969 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dept Of Health & Welfare Amh Psr Mt Home 1720 Westgate Dr Suite B-1 Boise ID 83704-7164 Ph: (208) 334-0894 | Idaho Dept Of Health & Welfare Amh Psr Mt Home 2420 American Legion Blvd Mountain Home ID 83647-3146 Ph: (208) 587-9061 |
| NPI Number | 1720118904 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720118904 | NPI | - | NPPES |
| 8073418 | Medicaid | ID | |
| 000010018973 | Other | BLUE SHIELD | |
| HW280 | Other | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Northern Star Healing, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1530 Fairway Street, Mountain Home, ID 83647 Phone: 208-794-0048 Fax: 855-471-0759 | |
Creating Options Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2390 American Legion Blvd, Mountain Home, ID 83647 Phone: 208-587-8095 | |
Sufficiency Advocate, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 235 N 3rd E, Mountain Home, ID 83647 Phone: 208-587-2900 Fax: 208-587-2992 | |
Emma Orthel Therapy, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 N 3rd E, Mountain Home, ID 83647 Phone: 208-490-6900 | |
Sequel Tsi Of Idaho Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2850 Industrial Way, Mountain Home, ID 83647 Phone: 208-587-2679 Fax: 208-587-2875 | |
Creating Options Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2390 American Legion Blvd, Suite 2, Mountain Home, ID 83647 Phone: 208-587-8095 Fax: 208-587-8025 |