Idaho Dept Of Health & Welfare Region 7 Cmh Psr Rexburg
Clinic/Center, Rehabilitation in Rexburg, ID. Organization (NPI-2).
NPI number1508992926
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1508992926
- Entity type
- Organization (NPI-2)
- Legal business name
- Idaho Dept Of Health & Welfare Region 7 Cmh Psr Rexburg
- Organization subpart
- No
- Enumeration date
- Feb 27, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0400X | Clinic/Center, Rehabilitation | – | – | Yes |
Practice location
333 Walker DrRexburg, ID 83440-1657
Phone 208-359-4751 · Fax 208-359-5461
Mailing address
333 Walker DrRexburg, ID 83440-1657
Phone 208-359-4751 · Fax 208-359-5461
Authorized official
Melissa M Bean
Program Manger
2085285706
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