IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH PSR ST MARIES

ST MARIES, ID
NPI1144357369
Entity TypeOrganization
Authorized ContactCORA JO GUSSENHOVEN
Program Manager
208-769-1406
Organization Subpart ?No
Primary Taxonomy261QM0801X 
Enumeration Date2007-02-27
Last Update Date2020-08-22
Business Address
IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH PSR ST MARIES
222 S 7TH ST
ST MARIES, ID 83861-1847
Phone number: 208-245-2541
Mailing Address
IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH PSR ST MARIES
PO BOX 248
ST MARIES, ID 83861-0248
Phone number: 208-245-2541
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IDAHO DEPT OF HEALTH & WELFARE REG 1 AMH