Organization
ST. JOSEPH'S REGIONAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHIVONNE MRAZ LCSW (OUTPATIENT MENTAL HEALTH MANAGER)
(208) 799-6500
Entity
Organization
Contact information
Practice address
428 6TH AVE, LEWISTON, ID 83501-2355
(208) 799-6500
Mailing address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
LMSW-34840
ID
Other
Enumeration date
09/05/2015
Last updated
09/05/2015
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