IDAHO DEPT OF HEALTH & WELFARE REG 1 CMH PSR CDA

COEUR D ALENE, ID
NPI1164550455
Entity TypeOrganization
Authorized ContactCORA JO GUSSENHOVEN
Program Manager
208-769-1406
Organization Subpart ?No
Primary Taxonomy261QR0400X Clinic/Center, Rehabilitation
Enumeration Date2007-03-01
Last Update Date2020-08-22
Business Address
IDAHO DEPT OF HEALTH & WELFARE REG 1 CMH PSR CDA
1250 IRONWOOD DR STE 100
COEUR D ALENE, ID 83814-2628
Phone number: 208-769-1515
Mailing Address
IDAHO DEPT OF HEALTH & WELFARE REG 1 CMH PSR CDA
1250 IRONWOOD DR STE 100
COEUR D ALENE, ID 83814-2628
Phone number: 208-769-1515
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