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Organization
IDAHO DEPT OF HEALTH & WELFARE REG 6 CMH POC CLINIC
Active
Organization
IDAHO DEPT OF HEALTH & WELFARE REG 6 CMH POC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITCHIE WEERS (CLINICAL SUPERVISOR)
(208) 234-7900
Entity
Organization
Contact information
Practice address
421 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 234-7900
(208) 236-6328
Mailing address
421 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 234-7900
(208) 236-6328
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/08/2007
Last updated
10/22/2010
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