| Open Mind Wellness | |
|
5920 N Government Way #4 Dalton Gardens ID 83815-9200 | |
| (208) 819-0550 | |
| Not Available |
| Full Name | Open Mind Wellness |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5920 N Government Way, Dalton Gardens, Idaho |
| Authorized Official Name and Position | Michael Daniel Garcia (OWNER) |
| Authorized Official Contact | 2088190550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Mind Wellness 5920 N Government Way #4 Dalton Gardens ID 83815-9200 Ph: (208) 819-0550 | Open Mind Wellness 5920 N Government Way #4 Dalton Gardens ID 83815-9200 Ph: (208) 819-0550 |
| NPI Number | 1699155457 |
|---|---|
| Provider Enumeration Date | 06/05/2015 |
| Last Update Date | 06/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699155457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LPC-5123 (Idaho) | Primary |
Diversified Social Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5624 N Government Way Ste 7b, Dalton Gardens, ID 83815 Phone: 208-762-9890 Fax: 208-762-9892 |