Eastport Psr, L.l.p.
NPI #1083831556 in Bonners Ferry, Idaho
Provider Information
- NPI Number
- 1083831556
- Entity Type
- Organization
- Organization Name
- Eastport Psr, L.l.p.
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Apr 19, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 7222 MAIN STREET
- City
- Bonners Ferry
- State
- Idaho
- ZIP Code
- 83805
- Phone
- (208) 946-3604
Authorized Official
- Name
- MS. ANNA LEE HARRIS, BA
- Title
- PSYCHOSOCIAL REHABILITATION SPECIAL
- Phone
- 12082677290
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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