Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda

LBN: Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda
Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda is an health care organization with primary practice located at 1250 Ironwood Dr Ste 100 , Coeur D Alene ID 83814-2628. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, which is considered as the primary health care specialty. Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda can be contacted via phone (208) 769-1515, or through Gussenhoven, Cora Jo via phone (208) 769-1406.

Contact Information

Primary practice address
1250 Ironwood Dr Ste 100 Coeur D Alene ID 83814-2628
Phone: (208) 769-1515
Fax: (208) 666-6744
Website:
Map and Directions
Authorized official contact:
Name: Gussenhoven, Cora Jo
Phone: (208) 769-1406

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation 261QR0400X

Profile Details

NPI number 1164550455
LBN Legal business name Idaho Dept Of Health & Welfare Reg 1 Cmh Psr Cda
DBA Doing business as
Authorized official Gussenhoven, Cora Jo
Entity Organization
Organization subpart 1 No
Enumeration date Mar 1st, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164550455 NPPES
Other HW199 BLUE CROSS OF IDAHO
Other 000010018348 BLUE CROSS OF IDAHO
MEDICAID 0028408 BLUE CROSS OF IDAHO

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