| Sequel Alliance Family Services, Llc | |
|
212 Rodeo Dr Moscow ID 83843-9798 | |
| (208) 882-5960 | |
| (208) 882-0857 |
| Full Name | Sequel Alliance Family Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 212 Rodeo Dr, Moscow, Idaho |
| Authorized Official Name and Position | Mary Caudle (CBO DIRECTOR OF PATIENT ACCOUNTS) |
| Authorized Official Contact | 2568803339 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sequel Alliance Family Services, Llc 1131 Eagletree Ln Sw Huntsville AL 35801-6478 Ph: (256) 880-3339 | Sequel Alliance Family Services, Llc 212 Rodeo Dr Moscow ID 83843-9798 Ph: (208) 882-5960 |
| NPI Number | 1154744357 |
|---|---|
| Provider Enumeration Date | 01/24/2014 |
| Last Update Date | 01/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154744357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | W132383 (Idaho) | Primary |
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