Organization Name: | HEALTHWEST INC. |
NPI Number: | 1033595541 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MINDY STOSICH-BENEDETTI (CEO) |
Mailing Address: | 655 S 4th E Ste 600 Preston |
State: | ID US |
Postal Code: | 832631604 |
Phone Number: | 2088523200 |
Fax Number: | 2088520517 |
NPI Enumeration Date: | 08/06/2015 |
NPI Last Update Date: | 08/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |