Organization
ANGEL WINGS CENTER OF HEALING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BOBETTE RENEE PAGE LCSW (OWNER)
(208) 552-6900
Entity
Organization
Contact information
Practice address
808 PANCHERI DR., IDAHO FALLS, ID 83402
(208) 757-0330
Mailing address
808 PANCHERI DR, IDAHO FALLS, ID 83402-3344
(208) 552-6900
(208) 552-4973
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-27373
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2257711
CIGNA BEHAVIORAL HEALTH
ID
Enumeration date
05/03/2007
Last updated
08/22/2020
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