Organization
PANHANDLE BEHAVIOAL HEALTH
Active
Other names
Panhandle Horizons
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK ELMO WRIGHT PH.D. (OWNER)
(406) 745-0148
Entity
Organization
Contact information
Practice address
212 S 11TH ST, SUITE 5, COEUR D ALENE, ID 83814-4000
(208) 755-6121
(208) 667-2681
Mailing address
32126 ALLISON RD, ST IGNATIUS, MT 59865-9155
(406) 745-0148
(208) 667-2681
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806144500
—
ID
01
—
PSY90
PSYCHOLOGY LICENSE
ID
Enumeration date
03/10/2007
Last updated
08/07/2008
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