Organization
POCATELLO HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN E. ABREU (CFO)
(208) 239-1000
Entity
Organization
Contact information
Practice address
651 MEMORIAL DR, POCATELLO, ID 83201-4071
(208) 239-1222
Mailing address
PO BOX 4168, POCATELLO, ID 83205-4168
(208) 239-2065
(208) 239-3754
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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