Organization · Type 2 NPI
Idaho Dept of Health & Welfare Reg 1 CMH PSR Cda
Rehabilitation Clinic/Center · Coeur D Alene, ID
NPI number
1164550455
Active
Practice location
1250 Ironwood Dr Ste 100
Coeur D Alene, ID 83814-2628
Fax (208) 666-6744
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Rehabilitation Clinic/Center Primary | 261QR0400X | None listed |
Rehabilitation Clinic/Center: Definition to come...
About NPI 1164550455
Idaho Dept of Health & Welfare Reg 1 CMH PSR Cda's National Provider Identifier is 1164550455, issued on Mar 1, 2007. The primary taxonomy on file is Rehabilitation Clinic/Center (261QR0400X), and the practice location is in Coeur D Alene, ID. The record was last updated on Aug 22, 2020.