| Nview Behavioral Health Clinic Of Idaho Llc | |
|
3709 N Locust Grove Rd Ste 100 Meridian ID 83646-6450 | |
| (208) 957-5360 | |
| Not Available |
| Full Name | Nview Behavioral Health Clinic Of Idaho Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3709 N Locust Grove Rd Ste 100, Meridian, Idaho |
| Authorized Official Name and Position | Kimberly Kay Cordero (OWNER) |
| Authorized Official Contact | 2082497014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nview Behavioral Health Clinic Of Idaho Llc 13213 N Dechambeau Way Boise ID 83714-9429 Ph: (208) 249-7014 | Nview Behavioral Health Clinic Of Idaho Llc 3709 N Locust Grove Rd Ste 100 Meridian ID 83646-6450 Ph: (208) 957-5360 |
| NPI Number | 1114419363 |
|---|---|
| Provider Enumeration Date | 06/04/2018 |
| Last Update Date | 06/04/2018 |
| Medicare PECOS PAC ID | 9234473059 |
|---|---|
| Medicare Enrollment ID | O20181205002766 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114419363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 37650 (Idaho) | Primary |
| Provider Name | Wendy I Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750638730 PECOS PAC ID: 4587819644 Enrollment ID: I20130221000556 |
| Provider Name | Kimberly K Cordero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558817981 PECOS PAC ID: 3173876497 Enrollment ID: I20181101003257 |
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