Organization
STATE OF IDAHO DEPARTMENT OF HEALTH AND WELFARE
Active
Parent organization
STATE OF IDAHO DEPARTMENT OF HEALTH AND WELFARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF IDAHO DEPARTMENT OF HEALTH AND WELFARE
Authorized official
MICHELLE S MATLOCK (FINANCIAL UNIT SUPERVISOR)
(208) 475-2342
Entity
Organization
Contact information
Practice address
450 W STATE ST, BOISE, ID 83702-6056
(208) 475-2342
Mailing address
450 W STATE ST, BOISE, ID 83702-6056
(208) 475-2342
(208) 475-2342
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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