Organization
BLUE BIRD DAY PNW LLC
Active
Other names
Harbor House
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MAYBERRY LMSW (CLINICAL ADMINISTRATION)
(208) 659-2049
Entity
Organization
Contact information
Practice address
820 N. WILLIAM ST., POST FALLS, ID 83854-8657
(208) 818-5016
Mailing address
820 N. WILLIAM ST., POST FALLS, ID 83854-8657
(208) 818-5016
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/28/2025
Last updated
01/28/2025
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