IDAHO DEPT OF HEALTH & WELFARE REG 6 CMH POC CLINIC NPI 1780715045

NPI Information

IDAHO DEPT OF HEALTH & WELFARE REG 6 CMH POC CLINIC is an adolescent and children mental health clinic center in Pocatello, ID. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. IDAHO DEPT OF HEALTH & WELFARE REG 6 CMH POC CLINIC NPI is 1780715045. The provider is registered as an organization entity type.

The provider's business location address is:

421 MEMORIAL DR
POCATELLO, ID
ZIP 83201-008
Phone: (208) 234-7900
Fax: (208) 236-6328

The provider's authorized official is Ritchie Weers .
The authorized official title is Clinical Supervisor and has the following contact phone number (208) 234-7900.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 10/22/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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