IDAHO DEPT OF HEALTH & WELFARE REGION 4 CMH PSR BOISE NPI 1891825824

NPI Information

IDAHO DEPT OF HEALTH & WELFARE REGION 4 CMH PSR BOISE is a rehabilitation clinic center in Boise, ID. IDAHO DEPT OF HEALTH & WELFARE REGION 4 CMH PSR BOISE NPI is 1891825824. The provider is registered as an organization entity type.

The provider's business location address is:

1720 WESTGATE DR
SUITE D
BOISE, ID
ZIP 83704-164
Phone: (208) 334-0792
Fax: (208) 334-0812

The provider's authorized official is Gina Westcott .
The authorized official title is Program Manager and has the following contact phone number (208) 334-0969.

The enumeration date for this NPI number is 3/7/2007 and was last updated on 8/22/2020.

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

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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