| Watershed Wellness, Llc | |
|
120 E Lake St Ste 205 Sandpoint ID 83864-1366 | |
| (208) 304-1102 | |
| Not Available |
| Full Name | Watershed Wellness, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 120 E Lake St Ste 205, Sandpoint, Idaho |
| Authorized Official Name and Position | David Barth (OWNER) |
| Authorized Official Contact | 2083041102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Watershed Wellness, Llc 417 S Lavina Ave Sandpoint ID 83864-1144 Ph: (208) 304-1102 | Watershed Wellness, Llc 120 E Lake St Ste 205 Sandpoint ID 83864-1366 Ph: (208) 304-1102 |
| NPI Number | 1487334264 |
|---|---|
| Provider Enumeration Date | 07/18/2023 |
| Last Update Date | 07/18/2023 |
| Certification Date | 07/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487334264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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