Eagle Crest Life Services Inc

LBN: Eagle Crest Life Services Inc
Eagle Crest Life Services Inc is an health care organization with primary practice located at 212 S 11Th St Ste 3 , Coeur D Alene ID 83814-4000. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as the primary health care specialty. Eagle Crest Life Services Inc can be contacted via phone (208) 666-9162, or through Wheeler, Robert K via phone (208) 666-9162.

Contact Information

Primary practice address
212 S 11Th St Ste 3 Coeur D Alene ID 83814-4000
Phone: (208) 666-9162
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wheeler, Robert K
Phone: (208) 666-9162

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X

Profile Details

NPI number 1356500649
LBN Legal business name Eagle Crest Life Services Inc
DBA Doing business as
Authorized official Wheeler, Robert K
Entity Organization
Organization subpart 1 No
Enumeration date Jun 3rd, 2008
Last updated Feb 20th, 2009 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356500649 NPPES
Idaho MEDICAID 807336200

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