Idaho Dept of Health & Welfare Reg II Cmh Moscow

NPI #1720116551 in Moscow, Idaho

Provider Information

NPI Number: 1720116551
Entity Type: Organization
Organization Name: Idaho Dept of Health & Welfare Reg II Cmh Moscow
Primary Specialty: Clinic/Center - Rehabilitation
Enumeration Date: Mar 1, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1350 TROY HWY
City: Moscow
State: Idaho
ZIP Code: 83543-3995
Phone: (208) 882-0562

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rehabilitation — Rehabilitation	261QR0400X	Primary

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