Idaho Dept of Health & Welfare Reg 1 Amh Psr Kellogg
Idaho Dept of Health & Welfare Reg 1 Amh Psr Kellogg is a Mental Health Clinic/Center (Including Community Mental Health Center) in Kellogg, Idaho. Registered with an NPI since 2007.
- In the registry since
- 2007
Practice location Address checks out
35 Wildcat Way Ste BKellogg, ID 83837-2261
Phone: (208) 784-1351
Fax: (208) 784-1356
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Mental Health Clinic/Center (Including Community Mental Health Center) (primary) | Taxonomy 261QM0801X |
|---|
Record details
| NPI number | 1730216961 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Cora Jo Gussenhoven — Program Manager · (208) 769-1406 |
| NPI enumerated | February 27, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 35 Wildcat Way Ste B, Kellogg, ID 83837-2261 |