Portneuf River Center

NPI #1518006113 in Pocatello, Idaho

Provider Information

NPI Number: 1518006113
Entity Type: Organization
Organization Name: Portneuf River Center
Primary Specialty: Clinical Nurse Specialist - Psychiatric/Mental Health, Child & Adolescent
Enumeration Date: Feb 6, 2007
Last Updated: Jul 18, 2008

Practice Location

Address: 427 N ARTHUR AVE STE B
City: Pocatello
State: Idaho
ZIP Code: 83204-3006
Phone: (208) 233-2998

Authorized Official

Name: KATHLEEN WERNER-LEAP, CNS, NPP
Title: DIRECTOR
Phone: (208) 233-2998

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinical Nurse Specialist - Psychiatric/Mental Health, Child & Adolescent — Psychiatric/Mental Health, Child & Adolescent	364SP0807X	Primary

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