Organization
CHAROLAIS CARE VIII, INC
Active
Other names
Mountain View Center for Geriatric Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
CARLEEN WELLARD (EXECUTIVE ASSISTANT)
(208) 221-2019
Entity
Organization
Contact information
Practice address
500 POLK ST E, KIMBERLY, ID 83341-1618
(208) 423-5591
(208) 423-5651
Mailing address
2043 E CENTER ST, SUITE 212, POCATELLO, ID 83201-3300
(208) 233-4673
(208) 233-4750
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Enumeration date
07/01/2009
Last updated
10/26/2009
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