| Jjst Enterprises Corp. | |
|
343 E 4th N Suite 244 Rexburg ID 83440-6002 | |
| (208) 356-0088 | |
| Not Available |
| Full Name | Jjst Enterprises Corp. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 343 E 4th N, Rexburg, Idaho |
| Authorized Official Name and Position | Scott Kay Andersen (OWNER) |
| Authorized Official Contact | 2083560088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jjst Enterprises Corp. 343 E 4th N Suite 244 Rexburg ID 83440-6002 Ph: (208) 356-0088 | Jjst Enterprises Corp. 343 E 4th N Suite 244 Rexburg ID 83440-6002 Ph: (208) 356-0088 |
| NPI Number | 1164723334 |
|---|---|
| Provider Enumeration Date | 11/04/2010 |
| Last Update Date | 11/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164723334 | NPI | - | NPPES |
| 1508870676 | Other | ID | BLUE CROSS |
| 1508870676 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LCPC-2823 (Idaho) | Primary |
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