State of Idaho
State of Idaho is a Community/Behavioral Health Agency in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2016.
- Licensed in
- ID
- In the registry since
- 2016
Practice location Address checks out
1720 N Westgate DrBoise, ID 83704-7164
Phone: (208) 334-0824
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Community/Behavioral Health Agency (primary) | Taxonomy 251S00000X · Licence LCPC-5579 (ID) |
|---|
Record details
| NPI number | 1790131027 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Wayne Nubile — Clinical Supervisor · (208) 334-0824 |
| NPI enumerated | May 5, 2016 |
| Last updated in NPPES | May 5, 2016 |
| Mailing address | 2322 W State St, Boise, ID 83702-3161 |
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450 W State St, Boise, ID 83702-6056 · (208) 475-2342
-
State of Idaho Department of Health and Welfare
450 W State St, Boise, ID 83702-6056 · (208) 475-2342
-
Mr. Jeffrey Allen Stephens
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Nathaniel Stone
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