Idaho Dept of Health & Welfare Region 7 Amh Psr Rexburg

NPI #1316073190 in Rexburg, Idaho

Provider Information

NPI Number: 1316073190
Entity Type: Organization
Organization Name: Idaho Dept of Health & Welfare Region 7 Amh Psr Rexburg
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Feb 26, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 333 WALKER DR
City: Rexburg
State: Idaho
ZIP Code: 83440-1657
Phone: (208) 359-4751

Authorized Official

Name: MRS. MELISSA M BEAN, MA
Title: PROGRAM MANAGER
Phone: (208) 528-5706

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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