Organization
COMMUNITY WELLNESS CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATALINA STECKBAUER MS,RN (OWNER, MANAGER)
(208) 234-7199
Entity
Organization
Contact information
Practice address
1509 N ARTHUR AVE, POCATELLO, ID 83204
(208) 234-7199
(208) 234-8084
Mailing address
1509 N ARTHUR AVE, POCATELLO, ID 83204
(208) 234-7199
(208) 234-8084
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
000417300
ID
251J00000X
Nursing Care Agency
8053791
ID
251S00000X
Community/Behavioral Health Agency
000417100
ID
Other
Enumeration date
01/24/2007
Last updated
06/26/2013
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