| Idaho Dept Of Health & Welfare Region 7 Amh Psr Rexburg | |
|
333 Walker Dr Rexburg ID 83440-1657 | |
| (208) 359-4751 | |
| (208) 356-5461 |
| Full Name | Idaho Dept Of Health & Welfare Region 7 Amh Psr Rexburg |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 333 Walker Dr, Rexburg, Idaho |
| Authorized Official Name and Position | Melissa M Bean (PROGRAM MANAGER) |
| Authorized Official Contact | 2085285706 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho Dept Of Health & Welfare Region 7 Amh Psr Rexburg 333 Walker Dr Rexburg ID 83440-1657 Ph: (208) 359-4751 | Idaho Dept Of Health & Welfare Region 7 Amh Psr Rexburg 333 Walker Dr Rexburg ID 83440-1657 Ph: (208) 359-4751 |
| NPI Number | 1316073190 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316073190 | NPI | - | NPPES |
| HW181 | Other | BLUE CROSS OF IDAHO | |
| 8073446 | Medicaid | ID | |
| 000010019479 | Other | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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