# IDAHO DEPT OF HEALTH & WELFARE REGION 7 CMH CLINIC REXBURG

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447386867
- **Authorized official:** MRS. MELISSA M BEAN MA (PROGRAM MANAGER)
- **Authorized official phone:** (208) 528-5706

## Contact information

- **Practice address:** 333 WALKER DR, REXBURG, ID 83440-1657
- **Practice address phone:** (208) 359-4751
- **Practice address fax:** (208) 356-5461
- **Mailing address:** 333 WALKER DR, REXBURG, ID 83440-1657
- **Mailing address phone:** (208) 359-4751
- **Mailing address fax:** (208) 356-5461

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 08/22/2020