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Organization
BLUE BIRD DAY PNW LLC
Active
Organization
BLUE BIRD DAY PNW LLC
Active
Other names
Harbor House
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MAYBERRY LMSW (CLINICAL ADMINISTRATION)
(208) 659-2049
Entity
Organization
Contact information
Practice address
820 N. WILLIAM ST., POST FALLS, ID 83854-8657
(208) 818-5016
Mailing address
820 N. WILLIAM ST., POST FALLS, ID 83854-8657
(208) 818-5016
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/28/2025
Last updated
01/28/2025
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