Organization
PORTNEUF RIVER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN WERNER-LEAP CNS, NPP (DIRECTOR)
(208) 233-2998
Entity
Organization
Contact information
Practice address
427 N ARTHUR AVE STE B, POCATELLO, ID 83204-3006
(208) 233-2998
(208) 232-0881
Mailing address
427 N ARTHUR AVE STE B, POCATELLO, ID 83204-3006
(208) 233-2998
(208) 232-0881
Taxonomy
Speciality
Code
Description
License number
State
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
02/06/2007
Last updated
07/18/2008
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