Organization
MENTAL WELLNESS CLINIC OF COEUR D ALENE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY LAGROU (OWNER)
(208) 676-1003
Entity
Organization
Contact information
Practice address
1105 W IRONWOOD DR, COEUR D ALENE, ID 83814-2613
(208) 676-1003
(208) 676-1009
Mailing address
1105 W IRONWOOD DR, COEUR D ALENE, ID 83814-2613
(208) 676-1003
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/29/2016
Last updated
06/29/2016
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