| Snake River Counseling Center Llc | |
|
2635 Channing Way Suite B Idaho Falls ID 83404-7518 | |
| (208) 552-0490 | |
| (208) 552-2518 |
| Full Name | Snake River Counseling Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2635 Channing Way, Idaho Falls, Idaho |
| Authorized Official Name and Position | Juli Popejoy (BILLING MANAGER) |
| Authorized Official Contact | 2085252090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Snake River Counseling Center Llc 2635 Channing Way Suite B Idaho Falls ID 83404-7518 Ph: (208) 552-0490 | Snake River Counseling Center Llc 2635 Channing Way Suite B Idaho Falls ID 83404-7518 Ph: (208) 552-0490 |
| NPI Number | 1235401522 |
|---|---|
| Provider Enumeration Date | 02/01/2012 |
| Last Update Date | 02/24/2015 |
| Medicare PECOS PAC ID | 3779744263 |
|---|---|
| Medicare Enrollment ID | O20120410000327 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235401522 | NPI | - | NPPES |
| Provider Name | Joel Buxton |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1629157797 PECOS PAC ID: 0749441236 Enrollment ID: I20241206002099 |
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