Idaho Dept of Health & Welfare Cmh Clinic Boise

NPI #1205966249 in Boise, Idaho

Provider Information

NPI Number: 1205966249
Entity Type: Organization
Organization Name: Idaho Dept of Health & Welfare Cmh Clinic Boise
Primary Specialty: Clinic/Center - Adolescent and Children Mental Health
Enumeration Date: Mar 7, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1720 WESTGATE DR
Address 2: SUITE D
City: Boise
State: Idaho
ZIP Code: 83704-7164
Phone: (208) 334-0792

Authorized Official

Name: GINA WESTCOTT, M.A,
Title: PROGRAM MANAGER
Phone: (208) 334-0969

Specialties & Taxonomy Codes

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

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