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Organization
IDAHO DEPT OF HEALTH & WELFARE CMH CLINIC BOISE
Active
Organization
IDAHO DEPT OF HEALTH & WELFARE CMH CLINIC BOISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA WESTCOTT M.A, (PROGRAM MANAGER)
(208) 334-0969
Entity
Organization
Contact information
Practice address
1720 WESTGATE DR, SUITE D, BOISE, ID 83704-7164
(208) 334-0792
(208) 334-0812
Mailing address
1720 WESTGATE DR, SUITE D, BOISE, ID 83704-7164
(208) 334-0792
(208) 334-0804
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/07/2007
Last updated
08/22/2020
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