Idaho Dept of Health & Welfare Reg. II Amh Orofino

NPI #1235267055 in Orofino, Idaho

Provider Information

NPI Number: 1235267055
Entity Type: Organization
Organization Name: Idaho Dept of Health & Welfare Reg. II Amh Orofino
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Mar 1, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 416 JOHNSON AVE
City: Orofino
State: Idaho
ZIP Code: 83544-9516
Phone: (208) 476-7703

Authorized Official

Name: VICKI R. MALONE, MSW
Title: PROGRAM MANAGER
Phone: (208) 799-4440

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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