Organization
EASTPORT PSR, L.L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNA LEE HARRIS BA (PSYCHOSOCIAL REHABILITATION SPECIAL)
12082677290
Entity
Organization
Contact information
Practice address
7222 MAIN STREET, BONNERS FERRY, ID 83805
(208) 946-3604
(208) 267-1681
Mailing address
PO BOX 1093, BONNERS FERRY, ID 83805-1093
(208) 946-3604
(208) 267-1681
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/19/2007
Last updated
08/22/2020
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