NPI 1457696551

North Idaho College

Organisation Contractor Coeur D Alene, ID

Practice location

Address: 2120 N Lakewood Dr STE B, Coeur D Alene, ID 83814-2638
Phone: (208) 667-3179
Fax: (208) 667-5938

Authorised official

Name: Pearl Bouchard
Title: Director
Phone: (208) 667-3179

Registered specialties (2)

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Case Manager/Care Coordinator

Other Service Providers Taxonomy 171M00000X

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Registry record

NPI: 1457696551
Entity type: Organization
NPI issued: 30 Nov 2012
Record last updated: 30 Nov 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.