North End Children's Health Clinic

NPI #1144382797 in Boise, Idaho

Provider Information

NPI Number: 1144382797
Entity Type: Organization
Organization Name: North End Children's Health Clinic
Primary Specialty: Clinic/Center - Health Service
Enumeration Date: Dec 13, 2006
Last Updated: Apr 23, 2009

Practice Location

Address: 1655 W FAIRVIEW AVE STE 206
City: Boise
State: Idaho
ZIP Code: 83702-5190
Phone: (208) 395-0000

Authorized Official

Name: DR. LEONA JO'ANNE' CHURCH, CPNP
Title: PRESIDENT, BOARD OF DIRECTORS
Phone: (208) 395-0000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Clinic/Center - Primary Care — Primary Care	261QP2300X
Clinic/Center - Health Service — Health Service	261QH0100X	Primary

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