Organization
IDAHO STATE UNIVERSITY
Active
Parent organization
IDAHO STATE UNIVERSITY
Other names
ISU Meridian Counseling Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
IDAHO STATE UNIVERSITY
Authorized official
CYNTHIA LEE ROCK (CLINICS DIRECTOR OF OPERATIONS)
(208) 373-1743
Entity
Organization
Contact information
Practice address
1311 E CENTRAL DR, MERIDIAN, ID 83642-7991
(208) 373-1719
Mailing address
1311 E CENTRAL DR, MERIDIAN, ID 83642-7991
(208) 373-1719
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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