| Idaho Dept Of Health & Welfare Reg. Ii Amh Orofino | |
|
416 Johnson Ave Orofino ID 83544-9516 | |
| (208) 476-7703 | |
| (208) 476-3636 |
| Full Name | Idaho Dept Of Health & Welfare Reg. Ii Amh Orofino |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 416 Johnson Ave, Orofino, Idaho |
| Authorized Official Name and Position | Vicki R. Malone (PROGRAM MANAGER) |
| Authorized Official Contact | 2087994440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dept Of Health & Welfare Reg. Ii Amh Orofino Po Box 712 Orofino ID 83544-0712 Ph: (208) 476-7703 | Idaho Dept Of Health & Welfare Reg. Ii Amh Orofino 416 Johnson Ave Orofino ID 83544-9516 Ph: (208) 476-7703 |
| NPI Number | 1235267055 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235267055 | NPI | - | NPPES |
| HW264 | Other | BLUE CROSS OF IDAHO | |
| 000010018440 | Other | BLUE SHIELD | |
| 8073805 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
A To Z Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1275 Riverside Ave, Orofino, ID 83544 Phone: 208-476-7483 Fax: 208-476-3144 | |
Breakthrough Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12271 Hartford Ave, Orofino, ID 83544 Phone: 208-471-8079 Fax: 877-775-0174 | |
Riverside Recovery Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 155 Main Street, Orofino, ID 83544 Phone: 208-476-9393 Fax: 208-476-7932 |